Mandibular lymph node tuberculosis in an 11-year-old child managed without surgery: a case report.

Introduction and importance: Tuberculosis (TB) is a chronic infectious disease that can affect multiple anatomical sites. Although involvement of the maxillofacial region is rare, mandibular lymph node TB is particularly uncommon and may pose diagnostic challenges. Case presentation: An 11-year-old male patient presented with a persistent swelling on the right side of the mandible for 8 months. Initial clinical assessment suggested a benign condition, and multiple courses of antibiotics failed to produce improvement. Histopathological examination following surgical intervention revealed granulomatous inflammation with caseating necrosis, consistent with TB. The patient was successfully treated with antitubercular therapy without the need for extensive surgical management. Clinical discussion: Extrapulmonary TB, especially in the maxillofacial region, is difficult to diagnose due to nonspecific clinical and radiographic features. Persistent swellings that do not respond to conventional treatment should raise suspicion for TB. Histopathological evaluation plays a key role in confirming the diagnosis. Conclusion: TB should be considered in the differential diagnosis of atypical mandibular swellings in children. Early diagnosis and appropriate management are essential to avoid unnecessary treatments and ensure favorable outcomes.