Localized extrapulmonary tuberculosis misdiagnosed as a spinocellular carcinoma of the anus

Tuberculosis is a disease that appears mainly in a pulmonary form and is caused by Mycobacterium tuberculosis. In humans, it is caused by different bacteria of the mycobacterium family. Non all of the mycobacteria family subtypes can cause tuberculosis. In most common cases it is caused by mycobacterium tuberculosis, but also many other subtype species like mycobacterium Bovis, mycobacterium Avium, and bacillus Calmette-Guérin. In some rare cases, it can appear in an extra-pulmonary one. The skin form of tuberculosis represents a really small percentage of all tuberculosis cases - only 1.5% by the literature review. We present a case of a 74 years old male patient with extra-pulmonary tuberculosis manifested as an ulcer localized on the border between the skin and the hemi-mucosa of the anal canal. The ulcer manifested with symptoms of pain and moderate bleeding. A biopsy sample was taken from this lesion and was diagnosed as a squamous carcinoma. Examining the medical history of the patient revealed that he was operated once for basocellular carcinoma of the left infraorbital area and two times for squamous carcinoma of the skin of the lower lip and the skin on the periauricular zone on the left. In all the cases the diagnosis was proven with pathological biopsy examination. The patient underwent through an operation and the lesion on the anal canal was surgically treated with a total excision. The excisional specimen was sent for examination and it revealed a case of extra-pulmonary tuberculosis. Skin form of extra-pulmonary tuberculosis or cutaneous tuberculosis can mimic macroscopically and microscopically the development and progression of skin malignant diseases like squamous carcinoma. Patient cases with multiple appearances of skin malignancies should be examined for a form of extra-pulmonary tuberculosis which can mimic or be a factor for the development of skin neoplasms.