Tuberculosis presenting as Anterior Mediastinal Mass: A Case Report

Abstract

The mediastinum, located between the pleural sacs, has three compartments. The anteriormediastinum spans anteriorly from the sternum to the pericardium and brachiocephalic vesselsposteriorly. Common lesions in this area include thymomas, lymphomas, teratomatous neoplasms,and thyroid masses. A mediastinal mass in the setting of tuberculous meningoencephalitis is anuncommon presentation of tuberculosis. We present a case of a 20-year-old girl with fever andheadache diagnosed with tuberculous meningoencephalitis. A thorough workup revealed an anteriormediastinal mass, histopathologically diagnosed as tubercular in origin. Treatment involved surgeryand antituberculosis therapy. Tuberculosis can manifest uniquely, and an isolated mediastinalmass, especially in an immunocompetent individual, is unusual. Treatment typically involves acombination of antimicrobial medications, and in some cases, surgical intervention may be necessaryto address complications or persistent masses. This case emphasizes the importance of consideringtuberculosis as a diagnosis when a patient presents with a mass in the anterior mediastinum.