Prostate tuberculosis: A rare complication of pulmonary tuberculosis with malignant features mimicking prostate cancer

Prostate tuberculosis (PTB) is an extremely rare complication of pulmonary tuberculosis (TB) that is alien to many urologists due to unaccustomed prostate involvement, thus posing a high tendency of confusion with prostate cancer. A 55-year-old Nigerian male presented with lower urinary tract symptoms with micturition difficulty, characterized by dysuria and weak urine stream that did not improve with straining, urge incontinence, and feeling of incomplete bladder emptying, some months after the completion of anti-Koch chemotherapy. The assessment of chronic bladder outlet obstruction secondary to benign prostatic hyperplasia was done, following a digital rectal examination which showed malignant features. The finding prompted requests for serum prostate-specific antigen (PSA) level and prostate biopsy. PSA level was 22.6 ng/ml, whereas histopathological examination showed Langhans-type giant cells suggestive of PTB. There is a high chance of missing out PTB in the diagnosis. Hence, a high index of suspicion is crucial in all TB-burden countries to make a differential diagnosis of PTB from classical prostate cancer.