A Diagnostic Dilemma: Isolated Hepatic Tuberculosis as a Rare and Unusual Presentation of TB

Tuberculosis (TB) is the major problem being faced worldwide, particularly in developing countries, and therefore, it is important to recognize the unusual presentations of the disease. Although TB is primarily lung disease, it can affect several other organs such as bone, brain, liver, and intestine etc. Liver involvement in TB is not uncommon but isolated liver TB is the rarest form of TB. A common observation is that the mortality rate is higher in intra-abdominal TB as compared to pulmonary TB, but it is a difficult diagnosis to make, often requiring laparotomy. Liver tuberculoma is, in particular, rare, with fewer than 100 cases reported in the literature, most of which are secondary and associated with miliary TB. We present a case of primary hepatic tuberculoma in an immuno-competent host and illustrate how these cases can be managed non-surgically