A case of oral tuberculosis suspected malignancy

: Oral tuberculosis with pulmonary tuberculosis is very rare in Japan. A 45-year old man admitted to our hospital because of spontaneous teeth extraction and pain in oral cavity for the past 3 months. The painful granulation in palate and fistel of 7th tooth root defect in right upper gum were observed. The diagnosis of oral tuberculosis was made by the histological examination of biopsy material and positive smear test for M. tuberculosis in surface of granulation. Chest X-ray showed multicavitary lesions in bilateral upper lobs and spread shadows in bilateral lower lung fields. He was treated with chemotherapy (INH, RFP, SM and EB) and with tube feeding. Five month's chemotherapy was needed to achieve cured granulation and negative smear test for M. tuberculosis in sputum. He was discharged 10 months after admission.