Atypical Presentation of Spinal Tuberculosis Mimicking Metastatic Disease

This case report presents a 74-year-old male with back pain and difficulty walking, initially suggestive of metastatic lesions. Radiographic and positron emission tomography scan findings raised suspicions, leading to surgical intervention for biopsy. Unexpectedly, histopathological examination, gene expert, and culture analysis revealed spinal tuberculosis (TB), highlighting the deceptive nature of TB and its potential to mimic other pathologies. The case underscores the importance of maintaining a high index of suspicion for TB, especially in endemic regions like India, where atypical presentations are common. Comprehensive evaluation, including biopsy, culture, and genetic testing, remains crucial for accurate diagnosis and timely initiation of appropriate treatment, as demonstrated in this case. Through this report, we emphasize the need for vigilance in considering TB in the differential diagnosis of spinal lesions, ultimately improving patient outcomes through prompt diagnosis and management.