Three Interesting Cases of Primary Oral Tuberculosis Masquerading As Malignancy: Case Reports with Review of Literature.

Primary oral tuberculosis (TB) is very rare accounting for less than 1% of the cases. The clinical presentation is indistinguishable from other common oral lesions particularly squamous cell carcinoma in adults. A careful examination of punch biopsy with microbiological work-up is essential for correct diagnosis. Herein, we report three sporadic cases of primary oral tuberculosis presenting as mass lesions and masquerading as malignancy diagnosed on histopathological evaluation emphasizing the diagnostic approach and management, along with a review of the literature. Middle-aged patients (02 males and 01 female) presented with ulcero-proliferative oral lesion with regional lymphadenopathies. Two of the patients had a history of chronic tobacco chewing. The clinical diagnoses of squamous cell carcinoma were made. Moreover, one of the patients was also misdiagnosed as squamous cell carcinoma on biopsy from a private lab. All three patients showed characteristic necrotizing granulomatous inflammation which also demonstrated on Ziehl Neelsen staining. Diagnosing oral TB based on clinical symptoms and signs is very challenging. The purpose of this report is to inform clinicians and pathologists about various presentations of oral TB, as timely diagnosis and appropriate treatment, decrease morbidity and mortality, especially since TB is a curable disease.