Pancreatic Tuberculosis Mimicking Pancreatic Tumour in An Hiv‑Positive Patient: A Rare Case Report and Literature Review

Pancreatic tuberculosis (PT) is an exceedingly rare form of extrapulmonary tuberculosis, even in regions where tuberculosis is endemic. Its clinical and radiological presentation often mimics pancreatic malignancy, leading to diagnostic challenges and unnecessary surgical interventions. We report a case of isolated pancreatic tuberculosis in a 46‑year‑old HIV‑positive woman who presented with constitutional symptoms and a pancreatic head mass initially suspected to be a mucinous cystic neoplasm. Radiological imaging revealed a cystic pancreatic lesion with necrotic lymphadenopathy. Intraoperative frozen section demonstrated granulomatous inflammation, prompting cessation of the planned Whipple’s procedure. Histopathology confirmed caseating granulomas. The patient responded well to antitubercular therapy (ATT). This case highlights the importance of considering PT in the differential diagnosis of pancreatic masses, especially in immunocompromised patients, and emphasizes the role of EUS‑guided FNA in preventing unnecessary surgery.