Tuberculous Abscess in the Parasternal Region

Abstract

Chest wall tuberculosis is usually characterized by a painful soft solitary swelling on the chest wall. This mass, referred to as cold abscess, is a rare presentation of extrapulmonary tuberculosis. Lungs are the primary site of infection in most of the patients. A 40-year-old female patient without any chronic diseases or a history of tuberculosis underwent fine needle aspiration biopsy of a mass in the parasternal region. Histopathological diagnosis was consistent with granulomatous abscess. The aspiration material was positive for acid-fast bacilli. Surgical debridement was planned. The mass was totally excised under general anaesthesia. Pathological diagnosis was tuberculous granuloma. The rib below the mass and the sternal margin were intact. After the surgery, the patient was started on quadruple antituberculosis therapy (ethambutol, pyrazinamide, isoniazid, rifampicin). The patient was discharged on postoperative day 2. No recurrence was noted in the periodic controls performed for 4 times at 3-month intervals.