Abcès de la paroi thoracique et abdominale isolé : une forme exceptionnelle de tuberculose

Isolated thoracic parietal involvement is a very rare form of tuberculosis and multifocal localization is exceptional. It often poses a diagnostic problem with parietal tumours requiring recourse to surgical biopsy. We report a case of tuberculous abscess localized to the anterior and superior part of the chest wall with a second abdominal localization but without any pulmonary involvement. The patient was a woman of 56 years presenting with a one-year history of a swelling to the right of the sternum accompanied after several months by a second swelling to the right side of the abdomen. The radiological and biological investigations revealed a parietal tumour in two separate areas. The diagnosis was confirmed by histological examination of a surgical biopsy and bacteriological examination of a percutaneous aspirate of the collection. Standard anti-tuberculosis treatment was given for nine months with good clinical and radiological resolution. In this case report, we study the anatomical and clinical features of this condition and discuss the diagnostic difficulties.