Primary paraduodenal tuberculosis in its pseudotumoral form: A case report and review of the literature

Abstract

Abdominal tuberculosis presents with nonspecific clinical and radiological features, often leading to diagnostic and therapeutic delays. Retroperitoneal pseudo-tumoral tuberculosis is a rare radio-clinical entity, characterized by its atypical and confusing symptomatology. We present the case of a 48-year-old male patient with no significant medical history, who was admitted to our department with a right retroperitoneal tumor presented as right renal colic due to compression of the lumbar ureter. Initially misdiagnosed as a gastrointestinal stromal tumor (GIST) of the lower duodenal angle, the patient underwent duodenal wedge resection, right hemicolectomy, and resection of the right lumbar ureter. Pathological examination of the surgical specimen confirmed follicular tuberculosis. The patient was subsequently treated with antitubercular drugs for 6 months with a good follow-up. Retroperitoneal pseudo-tumoral tuberculosis exhibits a polymorphic and nonspecific clinical presentation in our setting, highlighting the importance of early endoscopic or image-guided biopsies to prevent unnecessary surgical interventions.

Keywords

• Pseudo-tumor
• Duodenal
• Tuberculosis
• Surgery
• Imaging