An Uncommon Presentation of Tuberculosis with Cervical Pott’s Disease Initially Suspected as Metastatic Lung Cancer

Abstract

Cervical Pott's disease is a rare clinical condition whose diagnosis is usually delayed. We report a case of lung tuberculosis (TB) and cervical Pott’s disease mimicking a metastatic lung cancer. The patient presented with persistent cervical pain. Radiologic examinations showed the presence of a lytic lesion of C3 vertebral body, associated with spinal cord compression. A CT scan of the thorax showed a lung nodule highly suspicious for malignancy in the apical region of right lung upper lobe. Neurosurgical decompression was performed. Unexpectedly, histological analysis showed the presence of an inflammatory infiltrate suggestive for TB infection. The patient was immediately treated with antituberculous drugs. Atypical forms of spinal TB, such as cervical TB, can be misdiagnosed as primary or metastatic cancers and lead to delay of treatment initiation that could be fatal. Awareness of this uncommon TB presentation is important to prevent morbidity and mortality associated with spinal cord injury and disease dissemination.