Sinonasal tuberculosis mimicking malignancy – Case report and review of literature

Abstract

Primary sinonasal tuberculosis (TB) is a rare form of TB even in developing countries where TB is prevalent, as it usually results from primary foci elsewhere in the body. It often poses a diagnostic dilemma. There are a few reported cases of primary sinonasal TB in literature. The aim of this study is to report another case of primary sinonasal TB. A 27-year-old female presented with 5 months history of nasal blockade and epistaxis. There was no history of cough, night sweat, malaise, anorexia, weight loss, or fever. Examination revealed a mass in the left nasal cavity extending up to the nasopharynx with contact bleeding. Computerized tomography scan showed a hyperdense lesion, suspected to be a tumor, involving the nasal septum and filling the entire left maxillary sinus with bony destruction of the anterolateral, posterior and medial walls. Chest X-ray, retroviral screening, and other biochemical results were essentially normal. The lesion was excised through lateral rhinotomy, and histology revealed sinonasal TB. Primary sinonasal TB is seldomly seen, meticulous and high index of suspicion in the context of clinical, radiological, and pathological characteristics remain paramount and critical in making an otherwise challenging diagnosis.