Tuberculosis, A Great Masquerader: A Case Report of Disseminated Multifocal Skeletal TB and Tracheoesophageal Fistulae Mimicking Metastatic Cancer

Disseminated tuberculosis (TB) can mimic metastatic disease because of its multi-organ involvement (including bones), which can make the diagnosis much more complicated. Tracheoesophageal fistula is a very uncommon manifestation of TB, as is multifocal skeletal TB. There are reports of TB presenting either as multifocal skeletal TB or as tracheoesophageal fistulae, but we could not find any case reports describing both of these entities in a single patient and essentially mimicking a metastatic oesophageal neoplasm. However, we here describe one such case, which was managed medically. LEARNING POINTS: Disseminated tuberculosis (TB) can involve any system and may mimic many conditions. Tracheoesophageal fistula secondary to TB and multi-focal skeletal TB are both rare individually, with their co-occurrence being even more uncommon. Diagnosing and managing TB in endemic areas can be complex and challenging; the use of histopathology and molecular techniques prior to treatment is very important.