All psoas Abscesses Are Not Tuberculous: A Case Report of an Atypical psoas Abscess

It is usually assumed that a psoas abscess is tuberculous in etiology. A high index of clinical suspicion is required in the present clinical scenario with the increased incidence of various immunosuppressive conditions like HIV, post-transplant and malignancies. A case of advanced carcinoma of the cervix presenting as a psoas and inguinal abscess like mass with Myositis of thigh muscle was diagnosed in a HIV negative 49yr women. The psoas abscess like lesion was initially considered to be due to tuberculosis. On detailed evaluation and tissue biopsy the lesion was diagnosed to be due to metastatic carcinoma of the cervix with infiltration and destruction of iliac bone and acetabular wall. This type of advanced presentation with bone destruction metastasis is reported in HIV positive patients only. The purpose of this case report is to bring attention towards various causes of psoas abscess with Myositis of thigh and always have to be tissue proven for pyogenic and tuberculosis. A brief review of literature was done for this unusual tumour type presentation.