Abstract
INTRODUCTION AND IMPORTANCE: Tuberculosis (TB) remains a significant public health issue, especially in developing countries where its incidence is rising due to factors like overcrowding and immunosuppression. Among extrapulmonary TB forms, abdominal TB is common, while retroperitoneal TB is rare and often challenging to diagnose due to its similarity to other retroperitoneal tumors. Diagnosis typically requires invasive procedures such as laparoscopy or laparotomy. CASE PRESENTATION: We report the case of a 45-year-old woman with Pott's disease leading to a large retroperitoneal tuberculous abscess. She presented with a right flank mass, chronic low back pain, weight loss, and fever. Imaging revealed spondylodiscitis at the L1-L2 vertebrae and a retroperitoneal collection. PCR confirmed Mycobacterium tuberculosis. Treatment involved abscess drainage and a 9-month anti-TB regimen. CLINICAL DISCUSSION: Retroperitoneal TB presents with non-specific symptoms, often delaying diagnosis. Imaging plays a crucial role in identifying abscesses, with CT and MRI being key tools. The treatment of retroperitoneal tuberculous abscesses includes surgical drainage and prolonged anti-tuberculosis therapy. Early diagnosis and a multidisciplinary approach are essential to managing this severe form of extrapulmonary TB. CONCLUSION: Retroperitoneal tuberculous abscesses, though rare, represent a severe form of extrapulmonary tuberculosis that requires increased clinical vigilance.