Aourarh Benayad, Aourarh Aziz, Belkouchi Omar, Ifrine Lahssan, Belkouchi Abdelkader, Belkouchi Lina, Saouab Rachida
Department of Gastroenterology I, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco.
Department of Surgery A, Ibn Sina Hospital, Mohammed V University, Rabat, Morocco.
Radiol Case Rep. 2024 Aug 13;19(11):4865-4870. doi: 10.1016/j.radcr.2024.07.083. eCollection 2024 Nov.
Abdominal tuberculosis presents with nonspecific clinical and radiological features, often leading to diagnostic and therapeutic delays. Retroperitoneal pseudo-tumoral tuberculosis is a rare radio-clinical entity, characterized by its atypical and confusing symptomatology. We present the case of a 48-year-old male patient with no significant medical history, who was admitted to our department with a right retroperitoneal tumor presented as right renal colic due to compression of the lumbar ureter. Initially misdiagnosed as a gastrointestinal stromal tumor (GIST) of the lower duodenal angle, the patient underwent duodenal wedge resection, right hemicolectomy, and resection of the right lumbar ureter. Pathological examination of the surgical specimen confirmed follicular tuberculosis. The patient was subsequently treated with antitubercular drugs for 6 months with a good follow-up. Retroperitoneal pseudo-tumoral tuberculosis exhibits a polymorphic and nonspecific clinical presentation in our setting, highlighting the importance of early endoscopic or image-guided biopsies to prevent unnecessary surgical interventions.
腹部结核表现为非特异性的临床和影像学特征，常导致诊断和治疗延迟。腹膜后假性肿瘤性结核是一种罕见的放射临床实体，其特点是症状不典型且令人困惑。我们报告一例48岁男性患者，既往无重大病史，因右腹膜后肿瘤压迫腰段输尿管导致右肾绞痛而入住我科。该患者最初被误诊为十二指肠下角的胃肠道间质瘤（GIST），接受了十二指肠楔形切除术、右半结肠切除术和右腰段输尿管切除术。手术标本的病理检查证实为滤泡性结核。患者随后接受了6个月的抗结核药物治疗，随访情况良好。在我们的病例中，腹膜后假性肿瘤性结核表现出多形性和非特异性的临床表现，强调了早期内镜或影像引导下活检对于避免不必要手术干预的重要性。
