Mandibular Tuberculosis Mimicking as Squamous Cell Carcinoma- A Case Report

Abstract

Introduction: The incidence of tuberculosis (TB) has been rising steadily, accompanied by growing global resistance to standard pharmacologic treatments. Oral manifestations of TB are rare and often nonspecific, typically presenting as mucosal ulceration. Bony involvement, leading to osteomyelitis, is infrequent, with mandibular TB osteomyelitis being particularly rare. This report presents a unique case of mandibular TB osteomyelitis initially mimicking squamous cell carcinoma (SCC) on clinical and radiographic evaluation. Method(s): A 46-year-old Indian male presented with a nine-month history of a non-healing ulcer on the left mandible and associated lower lip paraesthesia. MRI and CT imaging revealed a two centimetre focal lucency in the left mandible, with destruction of the lamina dura, inferior alveolar nerve canal, and buccal and lingual cortices, leading to an initial diagnosis of mandibular SCC. Result(s): Surgical extraction of the lower anterior teeth, curettage of cystic contents, and incisional biopsy of the mucosa were performed. Histopathological analysis confirmed necrotising granulomatous inflammation with acid-fast bacilli, indicative of tuberculosis. The patient was urgently referred to the respiratory team for further management. Conclusion(s): Oral TB manifestations are found in less than four percent of TB cases, and, in rare instances, oral lesions may precede pulmonary TB diagnosis. The recent resurgence of TB highlights the importance of considering TB in atypical, persistent oral lesions to ensure early diagnosis and treatment of this communicable disease.Copyright © 2025