Yildiz Ekemen Keles1, Gulnihan Ustundag1, Aslihan Sahin1, Dilek Yilmaz2, Eda Karadag Oncel1, Ahu Kara Aksay1, Ahmet Kaya3, Gulen Gul4, Can Bicmen5

1Health Sciences University Tepecik Training And Research Hospital, Department Of Pediatric Infectious Disease, İzmir, Türkiye
2Katip Celebi University, Department Of Pediatric Infectious Disease, Izmir, Türkiye
3Health Sciences University Tepecik Training And Research Hospital, Department Of Orthopedics And Traumatology, İzmir, Türkiye
4Health Sciences University Tepecik Training And Research Hospital, Department Of Pathology, İzmir, Türkiye
5Dr. Suat Seren Training And Research Hospital For Chest Diseases And Chest Surgery, Microbiology And Clinical Microbiology Laboratory, İzmir, Türkiye

Keywords: Bone tumor, mycobacterium tuberculosis complex, pcr, paraffin-embedded


Osteoarticular tuberculosis (TB) of the bone is a rare form of TB, accounting for 1-5% of all extra-pulmonary TB cases worldwide. An otherwise healthy 11-month-old girl complained of swelling on her right wrist and avoidance of using it. She had no history of trauma, fever, weight loss, or other systemic symptoms. A mass on the dorsolateral side of the right wrist, measuring about 4x5cm, was found. In magnetic resonance imaging results, it was reported that there was a mass lesion of lytic character (Ewing’s sarcoma) with periost reaction. Excisional biopsy was performed; non-necrotizing granuloma was found. Mycobacteriological culture could not be performed since the tissue specimen was formalin-fixed and paraffin-embedded. The biopsy material obtained from the bone has no fresh tissue; the M. TB complex was determined upon mycobacteriological molecular examination of the tissue specimen on the waxed block. Therapy lasted for nine months. TB of the bone should be among the differential diagnoses even in the absence of pulmonary involvement and constitutional symptoms of TB. For diagnosis, it is essential to culture for the mycobacterial subtype by tissue biopsy and confirms the culture material by PCR.

Conflict of Interest

The authors declared no conflicts of interest with respect to authorship and/or publication of the article.

Financial Disclosure

The authors received no financial support for the research and/or publication of this article.