Unusual sites of tuberculosis mimicking skeletal metastases: A case report

Jauhary, Thanthawy; Hayati, Fierly

doi:10.1016/j.radcr.2022.03.035

Cited by 5 publications

(4 citation statements)

References 11 publications

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“…Another important differential diagnosis is tuberculosis with bone involvement, which is considered to be a "great mimicker" of a malignancy; however, the sternum is among the rarest sites described under these circumstances, as opposed to, for instance, the spine or hip [86,87]. For example, Engin et al [87] introduced a case of extra-pulmonary tuberculosis with multiple locations, including the sternum, that initially presented as a suspected malignancy at 18 F-FDG PET/CT examination.…”

Section: A Matter Of Differential Diagnosis: Sternal Metastasesmentioning

confidence: 99%

Sternum Metastases: From Case-Identifying Strategy to Multidisciplinary Management

Carsote,

Terzea,

Vasilescu

et al. 2023

Diagnostics

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We aimed to overview the most recent data on sternal metastases from a multidisciplinary approach (diagnosis strategies, outcome, and histological reports). This narrative review based on a PubMed search (between January 2020 and 22 July 2023) using key words such as “sternal”, “manubrium”, and “metastasis” within the title and/or abstract only included original papers that specifically addressed secondary sternal spreading of cancer in adults, for a total of 48 original articles (14 studies and 34 single case reports). A prior unpublished case in point is also introduced (percutaneous incisional biopsy was used to address a 10 cm sternal tumour upon first admission on an apparently healthy male). The studies (n = 14) may be classified into one of three groups: studies addressing the incidence of bone metastases (including sternum) amid different primary cancers, such as prostate cancer (N = 122 with bone metastases, 83% of them with chest wall metastases), head and neck cancers (N = 3620, 0.8% with bone metastases, and 10.34% of this subgroup with sternum involvement); and glioblastoma (N = 92 with bone metastases, 37% of them with non-vertebral metastases, including the sternum); assessment cohorts, including breast cancer (N = 410; accuracy and sensitivity of PET/CT vs. bone scintigraphy is superior with concern to sternum spreading) and bone metastases of unknown origin (N = 83, including a subgroup with sternum metastases; some features of PET/CT help the differentiation with multiple myeloma); and cohorts with various therapeutic approaches, such as palliative arterial embolization (N = 10), thymic neuroendocrine neoplasia (1/5 detected with sternum metastases), survival rates for sternum metastases vs. non-sternum chest wall involvement (N = 87), oligo-metastatic (sternal) breast cancer (3 studies, N = 16 for all of them), oligo-metastatic head and neck cancer (N = 81), conformal radiotherapy (N = 24,215, including an analysis on sternum spreading), and EBRT followed by MR-HIFU (N = 6). Core data coming from the isolated case reports (N = 34) showed a female to male ratio of 1.6; the females’ ages were between 34 and 80 (mean of 57.28) and the males’ ages varied between 33 and 79 (average of 58.78) years. The originating tumour profile revealed that the most frequent types were mammary (N = 8, all females) and thyroid (N = 9, both women and men), followed by bladder (N = 3), lung (N = 2), and kidney (N = 2). There was also one case for each of the following: adenoid cystic carcinoma of the jaw, malignant melanoma, caecum MiNEN, a brain and an extracranial meningioma, tongue carcinoma, cholangiocarcinoma, osteosarcoma, and hepatocellular carcinoma. To our knowledge, this is the most complex and the largest analysis of prior published data within the time frame of our methods. These data open up new perspectives of this intricate, dynamic, and challenging domain of sternum metastases. Awareness is a mandatory factor since the patients may have a complex multidisciplinary medical and/or surgical background or they are admitted for the first time with this condition; thus, the convolute puzzle will start from this newly detected sternal lump. Abbreviations: N = number of patients; n = number of studies; PET/CT = positron emission tomography/computed tomography; EVRT = external beam radiotherapy; MR-HIFU = magnetic resonance-guided high-intensity focused ultrasound; MiNEN = mixed neuroendocrine-non-neuroendocrine tumour.

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Section: A Matter Of Differential Diagnosis: Sternal Metastasesmentioning

confidence: 99%

Sternum Metastases: From Case-Identifying Strategy to Multidisciplinary Management

Carsote,

Terzea,

Vasilescu

et al. 2023

Diagnostics

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“…The incidence of extrapulmonary TB is 3%, and 10% are skeletal TB cases. Skeletal infections only occur in 1-5% of all tuberculosis infections and can appear as metastases in the differential diagnosis (Jauhary & Hayati, 2022). TB spondylitis accounts for 50% of cases of skeletal tuberculosis infection (Rajasekaran, et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Differentiation of Spinal Tuberculosis and Metastatic Spinal Tumor Using Mri Feature: A Systematic Review

Tsuroya¹,

Faris

Rahardjo³

2023

MBIOMJ

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Highlights1. Lesions that are regularly diagnosed in the spine include TB of the spine and tumors that have spread throughout the body.2. The examined papers included 35 individuals with tuberculous spondylitis and 31 patients with metastatic spinal malignancies.3. A methodology for MRI imaging and an accurate medical history will aid in establishing an accurate diagnosis. AbstractBackground: Spinal tuberculosis and metastatic tumors are commonly diagnosed lesions in the spine. Tuberculosis spondylitis, also known as Pott's Disease, is the most common extrapulmonary tuberculosis disease. MRI is the gold standard for early diagnosis because there is no significant difference in the results of clinical manifestations and histopathological examination. A biopsy will usually be used for a final exam for diagnosis. Objective: To provide information to confirm the diagnosis of TB spondylitis cases and metastatic spinal tumors. Method: A literature search was conducted via PubMed, Science Direct, and Scopus by selecting studies according to inclusion and exclusion criteria. The quality and risk of bias assessments were performed using Joanna Briggs Institute (JBI) tools. Overall, 35 spinal tuberculosis and 31 metastatic spinal tumor patients from 2 studies were reviewed. Result: Of the 35 patients with tuberculous spondylitis and 31 patients with metastatic spinal tumors from the two studies reviewed. It was found that the thorax was the most common region. The following imaging findings were of statistical significance (p<0.05): skip lesion, solitary lesion, intraspinal lesion, concentric collapse, abscess formation (paraspinal, intraosseous, and epidural lesions), and syrinx formation. Conclusion: An MRI imaging protocol and correct medical history will help establish an accurate diagnosis. Skip lesions, abscesses, and modular lesion margins are considered for diagnosis.

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“…Also disseminated tuberculous infection affecting a single bone and manifesting as focal lytic cortical lesions is rare and unusual [ 2 , 4 ]. The odd sites of skeletal tuberculosis are the sternum, ribs, sternoclavicular joint, and calvaria [ 5 ]. In this case report, we present a rare case of focal lytic lesion in the lateral condyle of the femur of an adult.…”

Section: Introductionmentioning

confidence: 99%

Tuberculosis of the Lateral Condyle of the Femur: A Case Report

Mythilisri,

et al. 2023

Cureus

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Tuberculosis in India has been a constant health issue. The revised national tuberculosis control program has suggested antitubercular drug regimens according to WHO guidelines for pulmonary and extrapulmonary tuberculosis. Here is an uncommon case of an adult presenting with a single lytic lesion of the lateral condyle of the femur; he had no history of primary foci of pulmonary tuberculosis and curettage of the lesion and histopathological examination of the bone tissue showed tubercular etiology. The patient, hence, was started on antitubercular drugs and at a six-month follow-up, resolution of the lesion was noticed.

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Unusual sites of tuberculosis mimicking skeletal metastases: A case report

Cited by 5 publications

References 11 publications

Sternum Metastases: From Case-Identifying Strategy to Multidisciplinary Management

Sternum Metastases: From Case-Identifying Strategy to Multidisciplinary Management

Differentiation of Spinal Tuberculosis and Metastatic Spinal Tumor Using Mri Feature: A Systematic Review

Tuberculosis of the Lateral Condyle of the Femur: A Case Report

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