Abstract
A case is reported of a 56-year-old woman of Libyan origin presenting with dysphagia,
retrosternal pain and weight loss. Oesophago-gastroduodenoscony revealed an ulcerated
tumor in the upper oesophagus strongly suggesting a malignancy. A positive Mendel-Mantoux
test along with histological evidence of epitheloid cell granulomas and clinical findings
consistent with pulmonary and lymph node tuberculosis led to the presumptive diagnosis
of oesophageal tuberculosis. The diagnosis was later confirmed by positive bacteriological
cultures of oesophageal biopsies and gastric washings. It is very unusual for dysphagia
to be the presenting symptom of active adult tuberculosis. Oesophageal tuberculosis
is extremely rare and must be distinguished predominantly from oesophageal carcinoma.
