Tuberculoma with phlegmon‑like symptoms mimicking soft tissue sarcoma in the wrist: A case report

Hashimoto,Kazuhiko; Nishimura,Shunji; Oka,Naohiro; Kakinoki,Ryosuke; Akagi,Masao

doi:10.3892/mco.2018.1652

August-2018 Volume 9 Issue 2

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August-2018 Volume 9 Issue 2

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Case Report

Tuberculoma with phlegmon‑like symptoms mimicking soft tissue sarcoma in the wrist: A case report

Authors:
- Kazuhiko Hashimoto
- Shunji Nishimura
- Naohiro Oka
- Ryosuke Kakinoki
- Masao Akagi
View Affiliations / Copyright

Affiliations: Department of Orthopedic Surgery, Kindai University Hospital, Osaka‑Sayama, Osaka 589‑8511, Japan
Pages: 207-210
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Published online on: June 12, 2018

https://doi.org/10.3892/mco.2018.1652
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Abstract

Despite the increasing incidence of tuberculosis, even in developed countries like Japan, tuberculoma is a relatively uncommon disease. Furthermore, given the rarity of tuberculoma, a definitive diagnosis is often delayed. We herein present the case of a 79‑year‑old man who presented with an erythematous and warm mass in the left forearm. Radiography revealed calcification of the wrist's volar side, and magnetic resonance imaging revealed a mosaic pattern at the lesion. Soft tissue sarcoma of the wrist was suspected, and an incisional biopsy was performed, which revealed numerous yellow rice bodies. A rapid pathological evaluation revealed caseous necrosis and Langhans giant cells, and a histological evaluation confirmed the diagnosis of tuberculoma. All the rice bodies were resected and the patient received postoperative antibiotic treatment with pyrazinamide, isoniazid, rifampicin and ethambutol. However, the patient developed hepatic insufficiency during treatment, and the regimen was discontinued. The patient had not experienced recurrence 1 year after the treatment. In conclusion, tuberculoma should be considered in the differential diagnosis of a wrist mass mimicking an inflamed soft tissue tumor.

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1	Li CR, Li YZ, Li YM and Zheng YS: Dynamic and contrast enhanced CT imaging of lung carcinoma, pulmonary tuberculoma and inflammatory pseudotumor. Eur Rev Med Pharmacol Sci. 21:1588–1592. 2017.PubMed/NCBI
2	Ju HB, Guo DM and Chen FF: Intramedullary cervical tuberculoma: A case report with note on surgical management. Int Surg. 100:133–136. 2015. View Article : Google Scholar : PubMed/NCBI
3	Anoumou MN, Kouame M, Daix T and Yepie A: Tuberculosis tenosynovitis of the flexor tendons in the wrist: A case report. Acta Orthop Traumatol Turc. 48:690–692. 2014. View Article : Google Scholar : PubMed/NCBI
4	Woon CY, Phoon ES, Lee JY, Puhaindran ME, Peng YP and Teoh LC: Rice bodies, millet seeds and melon seeds in tuberculous tenosynovitis of the hand and wrist. Ann Plast Surg. 66:610–617. 2011. View Article : Google Scholar : PubMed/NCBI
5	Ergun T, Lakadamyali H and Aydin O: Multiple rice body formation accompanying the chronic nonspecific tenosynovitis of flexor tendons of the wrist. Radiat Med. 26:545–548. 2008. View Article : Google Scholar : PubMed/NCBI
6	Sbai MA, Benzarti S, Bouzaidi K, Sbei F and Maalla R: A rare localization of tuberculosis of the wrist: The scapholunate joint. Int J Mycobacteriol. 4:161–164. 2015. View Article : Google Scholar : PubMed/NCBI
7	Baidoo PK, Baddoo D, Ocloo A, Agbley D, Lartey S and Baddoo NA: Tuberculous tenosynovitis of the flexor tendons of the wrist: A case report. BMC Res Notes. 11:2382018. View Article : Google Scholar : PubMed/NCBI
8	Hoffman KL, Bergman AG, Hoffman DK and Harris DP: Tuberculous tenosynovitis of the flexor tendons of the wrist: MR imaging with pathologic correlation. Skeletal Radiol. 25:186–188. 1996. View Article : Google Scholar : PubMed/NCBI
9	Kouassi KJ, Yao LB, Sery BJLN, M'bra KI, Krah KL, Lohourou GF and Kodo M: Dorsolumbar cold abscess revealing Pott's disease. Pan Afr Med J. 27:22017.PubMed/NCBI
10	Higuchi S, Ishihara S, Kobayashi H and Arai T: A mass lesion of the wrist: A rare manifestation of tuberculosis. Intern Med. 47:313–316. 2008. View Article : Google Scholar : PubMed/NCBI
11	Lall H, Nag SK, Jain VK, Khare R and Mittal D: Tuberculous extensor tenosynovitis of the wrist with extensor pollicis longus rupture: A case report. J Med Case Reports. 3:1422009. View Article : Google Scholar
12	Reise H: Die Reiskorpschen in tuberculserkrankensynovalsacken. Dtsch Z Chir. 42:11895.(In German).
13	Popert AJ, Scott DL, Wainwright AC, Walton KW, Williamson N and Chapman JH: Frequency of occurrence, mode of development and significance or rice bodies in rheumatoid joints. Ann Rheum Dis. 41:109–117. 1982. View Article : Google Scholar : PubMed/NCBI
14	Wali H, Al-Khuwaitir S and Hafeez MA: Compound palmar ganglion: A case report and literature review. Ann Saudi Med. 6:55–59. 1986. View Article : Google Scholar : PubMed/NCBI
15	Cao J, Mi Y, Shi C, Bian Y, Huang C, Ye Z, Liu L and Miao L: First-line anti-tuberculosis drugs induce hepatotoxicity: A novel mechanism based on a urinary metabolomics platform. Biochem Biophys Res Commun. 497:485–491. 2018. View Article : Google Scholar : PubMed/NCBI
16	Chang LY, Lee CH, Chang CH, Lee MC, Lee MR, Wang JY and Lee LN: Acute biliary events during anti-tuberculosis treatment: Hospital case series and a nationwide cohort study. BMC Infect Dis. 18:642018. View Article : Google Scholar : PubMed/NCBI
17	Jaovisidha S, Chen C, Ryu KN, Siriwongpairat P, Pekanan P, Sartoris DJ and Resnick D: Tuberculous tenosynovitis and bursitis: Imaging findings in 21 cases. Radiology. 201:507–513. 1996. View Article : Google Scholar : PubMed/NCBI
18	Regnard PJ, Barry P and Isselin J: Mycobacterial tenosynovitis of the flexor tendons of the hand. A report of five cases: J Hand Surg. 21:351–354. 1996.

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Tuberculoma with phlegmon‑like symptoms mimicking soft tissue sarcoma in the wrist: A case report

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