Surgical Treatment of Chest Wall Tuberculosis

Background: Tuberculosis remains a formidable challenge to health care providers in developing countries and chest wall tuberculosis is a rare entity .Its clinical presentation may resemble a pyogenic abscess or chest wall tumor. There is still controversy regarding the diagnosis and treatment of chest wall tuberculosis. Materials and Methods: During a 10-year period (1998–2009), 12 cases with chest wall tuberculosis were managed by our team. Patients’ medical records were retrospectively reviewed. After confirming the diagnosis by histopathological examination, patients underwent surgical management. Results: There were 8 male and 4 female patients. Patients’ age ranged from 4 to 60 years. Eight patients had a fluctuating abscess and 4 had a chest wall mass. Surgical procedure was drainage along with debridement in 6 patients, wide debridement along with rib resection in 2 patients and wide debridement along with chest wall resection and reconstruction in 4 patients. Recurrence of cold abscess and fistula formation were detected in 2 patients after a follow-up of 1 to 5 years. Outcome of patients with chest wall tuberculosis was good. Conclusion: chest wall tuberculosis mimics symptoms and signs of chest wall tumors or abscesses. The combination of symptoms and radiographic findings suggests the diagnosis of tuberculosis. Wide debridement and resection are shown to have lower rates of fistula formation, sinus formation and recurrence. Medical treatment must be started immediately after surgery.