Tuberculous osteomyelitis masquerading as tumors and tumor-like lesions: A clinico-radiological study of 20 patients.

Background: Tuberculous osteomyelitis is uncommon and may present with varied clinical and radiological presentations. This study aimed to elaborate on how these lesions mimicked different tumors or tumor-like lesions and their successful outcome with antitubercular therapy (ATT). Methods: A retrospective review of 20 patients with tuberculous osteomyelitis who presented as tumors or tumor-like lesions of bone in the last 10 years. All these were histopathologically proven lesions. Eleven cases with sequestrations required curettage for the extensive lesions. All twenty received ATT for 12 months. Results: There were 12 males and eight females, with ages ranging from 3 to 61 years (an average of 22.15). Eight cases presented like bone cysts in the metaphyseal area of the long bones, with one cystic lesion in the body of the talus. 2 mimicked chondroblastoma and one patient each, like giant cell tumors and osteoid osteomas, respectively. One patient had multifocal lytic lesions resembling metastasis or multiple myeloma. One patient had two lesions involving the clavicle and the proximal phalanx of the little finger). One lesion in the metatarsal and five in the phalanges of the hand mimicked chondromas. All resolved well, with no residual disability after receiving ATT. Conclusions: In endemic countries, tuberculosis should always be considered one of the differential diagnoses for lytic bone lesions. Histopathological confirmation is the gold standard for the diagnosis. These can be effectively treated with anti-tubercular medication.