Coexistence of rectal adenocarcinoma and rectal and lymph node tuberculosis: a case report with a limited narrative review
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By
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Sanbao Shi
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Da Li
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Peng Xu
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Cheng Zhang
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June 11, 2026
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Clinical Scorecard: Concurrent Rectal Adenocarcinoma and Tuberculosis of the Rectum and Lymph Nodes: A Case Study with a Brief Literature Review
At a Glance
| Category | Detail |
|---|
| Condition | |
| Key Mechanisms | |
| Target Population | Patients with a history of pulmonary tuberculosis presenting with rectal cancer and potential concurrent tuberculosis. |
| Care Setting | |
Key Highlights
- Rectal cancer and intestinal tuberculosis can present with overlapping symptoms.
- Preoperative molecular tuberculosis screening was not initiated despite the patient's history.
- Postoperative pathology revealed granulomatous inflammation and positive TB DNA PCR.
- A high index of suspicion is necessary for accurate differential diagnosis.
- Concurrent tuberculosis can complicate tumor staging and postoperative management.
Guideline-Based Recommendations
Diagnosis
- Utilize comprehensive pathological and molecular evaluations for accurate diagnosis.
- Integrate clinical, radiological, endoscopic, histopathological, and microbiological findings.
Management
- Consider neoadjuvant chemoradiotherapy followed by surgical intervention.
- Initiate systemic anti-tuberculosis therapy if tuberculosis is confirmed.
Monitoring & Follow-up
- Monitor for postoperative complications such as infections and anal discharge.
Risks
- Risk of misdiagnosis leading to delayed treatment of tuberculosis.
Patient & Prescribing Data
Neoadjuvant chemoradiotherapy was complicated by severe myelosuppression, as noted in the case presentation.
Clinical Best Practices
- Maintain a high index of suspicion for concurrent tuberculosis in patients with rectal cancer.
- Conduct thorough patient history and imaging studies to avoid misdiagnosis.
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