Lymph node tuberculosis after melanoma treatment - sometimes the patient is lucky

Vol. 57 No. 4, 2016

ROMANIAN JOURNAL of MORPHOLOGY and EMBRYOLOGY

Cristina Calarasu, Isabela Silosi, Augustin Mircea Cupsa, Ileana-Octavia Petrescu, Costin Teodor Streba, Viorel Biciusca, Maria Fortofoiu, Dragos-Marian Popescu

Tuberculosis (TB) is considered a pulmonary disease that can however disseminate to other organs through hematogenous dissemination following primary TB infection. Evolution of the disease can either be precocious, before healing of the primary infection, or late after primary infection, due to reactivation of initial lesions usually because of simultaneous immunosuppressive factors such as diabetes, renal disease, hepatic disease or different type of immunosuppressing treatments. Rare cases when tuberculosis and cancer are diagnosed at the same time create diagnostic difficulties and therapeutic challenges. We present the case of an asymptomatic 52-year-old female that was diagnosed by chance, at the right moment with a form of skin melanoma on the right forearm, for which she received a rather well tolerated cytostatic treatment. At the end of this treatment, she was also investigated for a breast mass that proved to be benign; however, enlarged lymph nodes were discovered in the right armpit were discovered upon further investigation. One of the lymph nodes was surgically removed, as first suspicion was of a metastasis from the skin melanoma. However, it was lymph node tuberculosis therefore anti-tuberculosis treatment was initiated. The patient tolerated the treatment with minor side effects. On few occasions, a patient can be diagnosed with incipient stages of skin melanoma and even more rarely the same patient is diagnosed and treated prematurely for lymph node tuberculosis. Sometimes, a successful outcome needs an organized and well-educated patient and a little luck.

Corresponding author: Ileana-Octavia Petrescu, Associate Professor, MD, PhD; e-mail: ileana.petrescu@gmail.com

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