Key result
Anti-tuberculosis treatment shrinks a large adrenal TB mass mimicking malignancy after 3 years.
Why the study?
Adrenal tuberculosis usually presents bilaterally and has distinct CT characteristics differing from primary tumors, but unilateral cases mimicking malignancy are rare.
Case Report (n=1)
Unilateral adrenal tuberculosis can present with CT imaging characteristics mimicking a malignant tumor and responds to extended anti-tuberculosis therapy.
Supports considering adrenal TB in differentials for masses mimicking malignancy; hypothesis-generating for optimal therapy duration.
BACKGROUND: Adrenal tuberculosis usually presents with bilateral involvement. It has special characteristics in computed tomography (CT) images, such as small size, low attenuation in the center, and peripheral rim enhancement, which differ from those of primary tumors. CASE SUMMARY: A 42-year-old female presented to the hospital with low back pain. She had been diagnosed with hypertension as well as pulmonary and cerebral tuberculosis but denied having any fever, fatigue, anorexia, night sweats, cough, or weight loss. Abdominal CT revealed an irregular 6.0 cm × 4.5 cm mass with uneven density in the right adrenal gland, while the left adrenal gland was normal. No abnormalities were observed in plasma total cortisol (8 am), adrenocorticotropic hormone, aldosterone/renin ratio, blood catecholamines, or urine catecholamines. A fine-needle aspiration biopsy of the right adrenal gland provided evidence of tuberculosis. After three years of anti-tuberculosis treatments, the large mass in the right adrenal gland was reduced to a slight enlargement. CONCLUSION: This is a case of unilateral adrenal tuberculosis with CT imaging characteristics mimicking those of a malignant tumor. Extended anti-tuberculosis therapy is recommended in such cases.
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Liu et al. (2022) conducted a case report in Unilateral adrenal tuberculosis (n=1). Anti-tuberculosis treatments was evaluated on Reduction of adrenal mass size. After three years of anti-tuberculosis treatments, a large 6.0 cm × 4.5 cm unilateral adrenal tuberculosis mass mimicking a malignant tumor was reduced to a slight enlargement.
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