Chest Wall Mass in Infancy: The Presentation of Bone-Tumor-Like BCG Osteitis

Abstract EN

Chest wall mass in infancy is rare.

Malignant lesions are more common than infection or benign tumors.

This is a case of a 12-month-old girl who presented with a 2 cm mass at the right costal margin and poor weight gain.

Chest radiograph demonstrated a moth-eaten osteolytic lesion at the 8th rib.

The resection was performed, and a mass with pus content was found.

The positive acid fast stain (AFB) organism was noted.

Pathology confirmed caseous granulomatous inflammation compatible with mycobacterial infection.

However, QuantiFERON-TB Gold was negative, so Mycobacterium bovis (M.

bovis) osteitis is highly suspected.

She was treated with antimycobacterium drugs and showed good results.

Osteomyelitis can manifest by mimicking bone tumors.

Without a biopsy, the pathogen may go undetected.

So, interventions such as biopsy are warranted and avoid mass resection without indication.

High C-reactive protein (CRP), alkaline phosphatase (ALP), periosteal reaction of radiating spicules, and penumbra sign in magnetic resonance imaging (MRI) are helpful for discriminating osteomyelitis from bone tumor.