title: A case of pericardial tuberculoma presenting as a left anterior chest wall mass.
abstract: BACKGROUND
  Tuberculosis (TB) can present both in its pulmonary or extra-pulmonary forms. Cardiac tuberculoma previously described only after autopsy is continuously seen with the advent of more advanced imaging modalities.
  
  
  METHODS
  A 23-year-old male with a four month history of a progressively increasing left anterior thoracic wall mass of 5 cm in diameter was referred from oncology for clinical re-evaluation and for echocardiography. Systemic examination was essentially normal. Transthoracic and trans-oesophageal echocardiography showed the presence of a pericardial mass around the right atrioventricular junction. Thoracic CT scan showed an anterior mass in left chest wall extending to the pericardium and also the presence of mediastinal lymphadenopathy. Mantoux test was positive and histological examination of tissue biopsy confirmed the presence of TB. However, blood tests and culture of aspirated purulent fluid were unyielding. A diagnosis of pericardial tuberculoma with mediastinal and parietal extension was made and patient was successfully treated with standard anti-TB chemotherapy.
  
  
  CONCLUSIONS
  The possible differential diagnoses for chest wall tumors are varied and a high degree of suspicion is needed to diagnose cardiac tuberculoma especially in endemic regions. Imaging though helpful in morphological description cannot make precise diagnosis. The diagnosis depends on histological and culture studies. There is usually a good evolution with anti-TB treatment.
  
  
  CONCLUSIONS
  In an era of an increasing number of acquired immune-compromised patients, and with increasing number of diagnoses of tuberculosis, a diagnosis of cardiac tuberculoma should be considered in patients presenting with a thoracic wall mass.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Leye
authors.affiliation: Service de cardiologie, CHU Aristide Le Dantec, Dakar, Sénégal. modoujobe@gmail.com.
authors.forename: Modou
authors.initials: M
authors.lastname: Jobe
authors.forename: Souleymane
authors.initials: S
authors.lastname: Diatta
authors.forename: Mouhamadou Bamba
authors.initials: MB
authors.lastname: Ndiaye
authors.forename: Fatou
authors.initials: F
authors.lastname: Aw
authors.forename: Gabriel Nounignon Comlan
authors.initials: GN
authors.lastname: Deguenonvo
authors.forename: Alain
authors.initials: A
authors.lastname: Affangla
authors.forename: Pape Souleymane
authors.initials: PS
authors.lastname: Toure
authors.forename: Madoky Magatte
authors.initials: MM
authors.lastname: Diop
authors.forename: David Messika
authors.initials: DM
authors.lastname: Zeitoun