A case of oral mucosal tuberculosis resembling a malignancy in an immunocompromised patient

Abstract

Tuberculosis of the oral cavity is rare and is usually secondary to pulmonary Tuberculosis. The lungs are the most common sites of involvement. However, any organ may exhibit extrapulmonary involvement. We report a case of oral mucosal tuberculosis in an elderly man with oral mucosal ulcers. A man in his 80 s, with pemphigoid and renal dysfunction, was admitted to our department with intractable contact pain. Ulcers were undermined and had a saw-tooth appearance with granulation tissue formation in the left lower buccal gingiva. No abnormal bone resorption was observed on the panoramic graphs. A biopsy of the same area showed positive Ziehl-Neelsen staining, suggesting gingival inflammation due to tuberculosis. Upon consultation with the Department of Respiratory Medicine at our hospital, tuberculosis was diagnosed based on positive results of the sputum loop-mediated isothermal amplification method. The patient had a history of pulmonary tuberculosis and was taking steroids to treat pemphigoid. Tuberculosis recurrence is likely due to immunosuppression resulting from aging, underlying diseases, and steroid therapy. Care is required when diagnosing these patients. Oral mucosal tuberculosis should be considered in patients with refractory oral ulcers, contact pain, or a history of pulmonary tuberculosis.