Exceptional association of hepatic and pancreatic tuberculosis mimicking metastatic pancreatic neoplasia: A case report and review of the literature

INTRODUCTION: Despite the high prevalence of tuberculosis in the world and especially in endemic areas such as Morocco, isolated hepatic and pancreatic tuberculosis and pancreatic tuberculosis remain rare and pose a real diagnostic problem. CASE PRESENTATION: We report a case illustrating an exceptional association of pancreatic tuberculosis with hepatic tuberculosis in a 44-year-old immunocompetent woman, in whom the presence of a pancreatic mass on imaging suggested a neoplastic origin. The diagnosis was rectified after bacteriological and pathological study of the CT-guided percutaneous biopsy specimens. DISCUSSION: The symptomatology of pancreatic and hepatic tuberculosis is unspecific and polymorphic and can mimic any intra-abdominal pathology. Abdominal ultrasound is often the first imaging modality used. The diagnosis of certainty is bacteriological. The treatment of pancreatic and hepatic tuberculosis is identical to the other extrapulmonary tuberculosis. the anti-bacillary drugs are the gold standard. Surgery is reserved for complicated forms. CONCLUSION: The diagnosis of hepatic and pancreatic tuberculosis is a challenge for the clinician. The treatment is usually medical and based on antituberculosis treatment; surgery may be necessary in case of complications.