Citation: F. Z. Abakka et al. Pseudo Tumoral Form of Mediastinal Tuberculosis: Case Report. Sch J Med Case Rep, 2021 Apr 9(4): 455-458. 455 Scholars Journal of Medical Case Reports Abbreviated Key Title: Sch J Med Case Rep ISSN 2347-9507 (Print) | ISSN 2347-6559 (Online) Journal homepage: https://saspublishers.com Pseudo Tumoral Form of Mediastinal Tuberculosis: Case Report F. Z. Abakka 1* , I. Zouita 1 , Y. Zouine 1 , D. Basraoui 1 , H. Jalal 1 1 Radiology Mother Child Department, CHU Mohammed VI, University Cadi Ayad, Marrakech, Morocco DOI: 10.36347/sjmcr.2021.v09i04.042 | Received: 17.03.2021 | Accepted: 26.04.2021 | Published: 30.04.2021 *Corresponding author: F. Z. Abakka Abstract Case Report Mediastinal pseudotumoral tuberculosis is a rare form of Mycobacterium tuberculosis infection, characterized by marked diagnostic difficulty due to the absence of specific clinical or biological signs and deceptive imaging mimicking a neoplastic pathology. In this article, we report a case of mediastinal pseudotumoral tuberculosis that was treated with a thoracic CT scan and a dorsal MRI scan, which showed a posterior mediastinal lesion process infiltrating the spinal canal and the dorsal soft tissues and suggesting a tumoral or infectious origin. The tubercular origin was retained in the face of presumptive arguments and the patient was treated as lymph node tuberculosis and put on anti-bacillary drugs based on streptomycin, rifampicin, isoniazid and pyrazinamide according to the 2RHZ/4RH protocol with a very good clinical and paraclinical evolution. Keywords: Mediastinal tuberculosis, biological signs, CT scan, rifampicin. Copyright © 2021 The Author(s): This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY-NC 4.0) which permits unrestricted use, distribution, and reproduction in any medium for non-commercial use provided the original author and source are credited. INTRODUCTION Tuberculosis is a public health problem [1] due to its widespread nature, particularly in developing countries. The mediastinal location is rare. Diagnosis is difficult due to the non-specific nature of its clinical signs and the absence of characteristic radiological findings. It can sometimes simulate a mediastinal tumor, which poses a diagnostic challenge for radiologists and clinicians [2]. OBSERVATION We report the case of a 13 years old patient, without any particular pathological history, hospitalized in our training for chronic (more than 1 year) intense, insomniating and radiating inter scapular chest pain associated with a wet cough, a fever of 39 C and night sweats. The clinical examination revealed a stature weight delay (-2DS), a dorsal spinal syndrome with a painful fixed swelling of right paravertebral tissue consistency, pain on palpation of the rib cage and scapula and slight intercostal traction. A BK assessment was performed: three sputum BKs came back negative, the expert gene negative and Quantiferon negative. The CT scan (Fig-1) was in favor of posterior locally infiltrating mediastinal posterior masses extended from D4 to D11 with intraductal extension. Further investigation by dorsal MRI (Fig-2) showed a pre- and latero-vertebral lesion process infiltrating the posterior mediastinum, the spinal canal and the dorsal soft tissues opposite, suggesting a tumor or infectious origin.