Unusual manifestations of chest wall tuberculosis: diagnostic challenges in two cases from a low-incidence tuberculosis country.

Abstract

Chest wall tuberculosis (TB) is a rare manifestation of extrapulmonary TB and may present a significant diagnostic challenge, particularly in low-incidence TB countries such as the United Arab Emirates. We report two unusual cases of chest wall TB with distinct clinical presentations. The first case presented as a slowly enlarging chest wall mass that clinically and radiologically mimicked a soft-tissue neoplasm and was ultimately diagnosed as giant tuberculous lymphadenitis. The second case presented as a large posterolateral chest wall abscess without evidence of active pulmonary TB. Both patients were managed surgically for diagnostic and therapeutic purposes, and histopathological examination established the diagnosis of chest wall TB. Both patients received a 6-month course of anti-tuberculous therapy with complete recovery. These cases highlight the diverse clinical spectrum of chest wall TB and emphasize that the disease should be considered in the differential diagnosis of chest wall masses and abscesses, even in low-incidence TB settings. Histopathological confirmation remains essential for establishing the diagnosis and guiding appropriate management.