A case report of coexisting breast cancer with peritoneal, cutaneous tuberculosis, and potential Pott’s disease: therapeutic and diagnostic challenges

Abstract

Introduction: Breast cancer affects one in eight women during their lifetime; it may coincide with other diseases due to its high prevalence. Different pathologies that occur simultaneously with breast cancer, or later during its course, lead to multiple interactions with cancer and have a significant impact on its management. Presentation of case: A 58-year-old Syrian female was admitted to our hospital for compliant of abdominal distension. Following complete examination, obtained biopsies confirmed the diagnosis of peritoneal tuberculosis. At a subsequent time, she suffered back pain and the computed tomography showed vertebral lesion with breast mass that was diagnosed as invasive lobular carcinoma (ILC) of the left breast. Vertebral lesion that appeared on radiologic assessment was diagnosed as cancer metastasis. However, the interaction of this metastasis with the proposed management diverted the attention towards its non-cancerous entity. Five months after completing the chemotherapy, biopsies revealed the recurrence of triple-negative (ER−, PR−, HER2− neu−) ILC of the breast. Ultimately, the patient was followed up for an overall duration of 4 years. Discussion: Latent tuberculosis infections may be activated by chemotherapy regimens that suppress immunity. Therefore, initial management of tuberculous infection is preferred when it coexists with cancer. Conclusion: Breast cancer is common and may co-present with other diseases, which, in some cases, produce mimicking lesions that alter its diagnosis. Pott’s disease, albeit a rare entity, has shown a resurgence in developed countries and should be considered in the differential diagnosis of vertebral lesions in patients with breast cancer.