Osteoarticular tuberculosis of the symphysis pubis presenting as a hypogastric cystic mass in a woman with primary Sjögren's syndrome

Abstract

A 79-year-old woman with primary Sjögren's syndrome and immune thrombocytopenia presented with a hypogastric cystic mass. Twenty-three months previously she received a 7-month course of prednisone at moderate doses to control the thrombocytopenia. A computed tomography showed a cystic mass, destruction of the left pubis with involvement of the symphysis and erosion of the right pubis. The cystic mass was surgically removed. Epithelioid granulomata were found on pathological examination and Mycobacterium tuberculosis was grown in Löwenstein medium. This is the first reported case of osteoarticular tuberculosis with such a presentation and only the second localized to the pubis.