Disseminated Tuberculosis Mimicking Malignancy: Case Report

Abstract

This case report describes an unusual presentation of disseminated tuberculosis (TB) in a young immunocompetent patient, initially resembling a malignancy. TB cases with characteristics that mimic neoplasms present diagnostic challenges, especially in regions with a high prevalence of the disease. The patient, a 23-year-old woman, presented with a mediastinal mass, elevated CA-125 levels, and a progressively severe clinical picture that included septic shock and acute renal failure. The clinical presentation and imaging findings initially suggested a neoplasm; however, the diagnosis of disseminated TB was confirmed through videothoracoscopy, PCR, and bronchoscopy. The patient received antituberculous therapy, resulting in clinical improvement and stabilization before hospital discharge. This case highlights the importance of considering TB in the differential diagnosis of mediastinal masses and complex presentations in immunocompetent individuals. Furthermore, it raises the possibility that CA-125, a marker commonly associated with malignancies, may have diagnostic utility in disseminated TB, warranting further investigation to explore its potential value in these contexts.