Chest wall tuberculosis: a surgical experience

<b>Introduction:</b> Unlike the pleural-pulmonary localization, chest wall is a rare localization of tuberculosis. This study highlights the difficulty in diagnosing parietal tuberculosis as well as the management of this extremely rare pathology. <b>Material:</b> Descriptive retrospective study over a period of 10 years involving 16 cases collected at the service of thoracic surgery at A. Mami Hospital in Tunisia. <b>Results:</b> There were 16 patients, 68% of whom were female. The average age was 42.87 years [29-64]. A history of tuberculosis was reported in one case and a notion of contamination in another. None of the patients had a history of immunosuppression. Clinically, the onset was insidious, marked by the appearance of a parietal tumefaction of 6cm on average, of soft consistency, not fistulized to the skin. Thoracic CT, performed in all patients, objectifyed a heterogeneous fluid collection, located next to the sternum:4 patients (25%), antero-basal:7 patients (43%), postero basal(18%), multiple anterior and posterior collections (13%) associated with bone erosion by contiguity (56%). All our patients underwent a diagnostic and therapeutic surgery. A costal resection was perfomed (5 cases), and a parietectomy of a segment of ribs (2 cases). The confirmation was histological. All Patients had anti-tuberculosis treatment for 9 months, with a good clinical and radiological evolution. After an average follow-up of 34 months, there were no recurrences. <b>Conclusion:</b> If there are no other lesions suggestive of tuberculosis, the diagnosis of chest wall tuberculosis&nbsp;can be difficult requiring&nbsp;a diagnostic and therapeutic surgery. However, surgical&nbsp;treatment alone&nbsp;remains insufficient and must be associated with medical tuberculosis treatment.