Tuberculosis and Respiratory Diseases  2009;67(4):318-324

doi:10.4046/trd.2009.67.4.318

Chest Wall Tuberculosis: Clinical Features and Treatment Outcomes.

Young Joo KIM 1 ; Hee Jung JEON ; Chang Ho KIM ; Jae Yong PARK ; Tae Hoon JUNG ; Eung Bae LEE ; Tae In PARK ; Kyung Nyeo JEON ; Chi Young JUNG ; Seung Ick CHA

Affiliations

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Keywords

Tuberculosis; Chest wall; Surgery; Computed tomography; Bone scintigram

Country

Republic of Korea

Language

English

Abstract

BACKGROUND: A diagnosis and treatment of chest wall tuberculosis (CWTB) is both difficult and controversial. The aim of this study was to collect information on the optimal treatment for CWTB. METHODS: The clinical features, radiographic findings, and treatment outcomes of 26 patients, who underwent surgery and were diagnosed histopathologically, were retrospectively analyzed. RESULTS: The most common presenting symptom was a palpable mass found in 24 patients (92.3%). In all patients, CT revealed a soft tissue mass that was accompanied by a central low density, with or without peripheral rim enhancement. The sensitivity and specificity of the bone scintigram for bone involvement were 87.5% and 100%, respectively. CWTB was diagnosed preoperatively by aspiration cytology and smear for acid-fast bacilli in five out of 11 patients. Twenty-three patients (88.5%) underwent a radical excision and three underwent incision/drainage or an incisional biopsy. The duration of antituberculous medication was 7.5+/-3.98 months with a follow-up period of 28.2+/-26.74 months. Among the 20 patients who completed their treatment, nine received chemotherapy for six months or less and 11 received chemotherapy for nine months or more. Two patients had a recurrence four and seven months after starting their medication. CONCLUSION: A 6 month regimen may be appropriate for CWTB patients who have undergone a complete excision.