Tuberculosis Presenting as Anterior Mediastinal Mass - A Possibility in An Immunocompetent Child

A case of an 8-year-boy is reported who presented with a two month history of high-grade fever, associated with reduction in his appetite and subjective weight loss. He was treated empirically on the lines of bronchopneumonia, however, with no relief in his symptoms. Chest radiograph showed mediastinal widening, which prompted the need for a computed tomographic (CT) scan of the chest revealing an anterior mediastinal mass abutting the pericardium and compressing the great vessels. The possibilities of lymphoma or germ cell tumour were considered. The serum tumor markers were unremarkable. The child underwent midline sternotomy, with complete excision of mass. The histopathology of the lesion revealed multiple epithelioid cell granulomas with necrosis, and final diagnosis of a tuberculous lesion was made. The clinical course of this patient and the relevant literature is presented in this paper.