Introduction: Mycobacterium tuberculosis is a disease seen in every tissue and organ. Although it often involves the lung and pleura, it can also progress into extrapulmonary tuberculosis. Soft tissue and bone tuberculosis are the least common of all tuberculosis types. In some cases, the lesions may appear like bone tumors or metastatic lesions. Bacteriological and histopathological studies reach a definitive diagnosis because of the biopsy. We present a case suggestive of Ewing's sarcoma with clinical and imaging findings diagnosed as soft tissue tuberculosis resulting from the biopsy.
Case: A two-year-old girl was admitted to our clinic with the complaint of palpable swelling on the left side of her chest. Ewing sarcoma was considered with the findings of Computed Tomography (CT), Magnetic Resonance Imaging (MRI), and PET-CT. Biopsy material was reported as casefied granulomatous inflammation, and M. tuberculosis complex DNA was detected by PCR examination of the tissue. The patient was successfully treated with rifampin, isoniazid, pyrazinamide, and ethambutol.
Conclusion: Today, it should be kept in mind that tuberculosis is a common disease, rarely isolated soft tissue or bone involvement, and can be confused with malignancy.
Abstract
Nephrotic syndrome is characterized by diffuse edema, massive proteinuria and hypoalbuminemia. It usually occurs between the ages of 2-6. Due to periorbital edema these patients are mistakenly diagnosed with allergic disease. A 4-year-old 9-month-old male patient, who had no known disease under follow-up, was admitted to the pediatric surgery service due to bilateral hydrocele and inguinal hernia, was planned to be operated on, and bilateral swelling in his eyes was noticed in the preoperative evaluation, was consulted to the pediatric immunology-allergy department. His general condition was good, his skin turgor was normal, his eyelids were edematous. There was bilateral pretibial pitting edema and bilateral transluminated swelling in the scrotum. In laboratory examination: Albumin: 1.6g/dl, Sedimentation:76 mm/hr, C3:1.23 mg/dl, and C4: 0.24 mg/dl. In urine: density: 1051, protein: +++, protein/creatinine was 17.8 mg/mg. Both nephrotic syndrome and angioedema cause severe edema of the eyelids and genital area. Therefore, laboratory tests, clinical findings and careful examination are sufficient for differential diagnosis. In our study, we aimed to present a case of nephrotic syndrome with a prediagnosis of allergic angioedema.
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