The diagnosis of a neck mass can present a challenge. In the adult the most common diagnosis is malignancy, and both primary and metastatic tumors should be considered. Other frequent options are infectious processes. We present the case of an 88-year-old female patient with a submandibular mass with inflammatory signs, unresponsive to antibiotic therapy, with fine needle aspiration biopsy showing an inflammatory lesion. The mass developed over a month with associated anorexia resulting in admission for diagnosis with open biopsy. Following admission, an invasive carcinoma of the right breast was diagnosed, and the Mycobacterial culture of the submandibular mass biopsy was positive for Mycobacterium tuberculosis. Immunosenescence the elderly contributes to vulnerability to cancers but also infections which can present atypically and thus result in delayed diagnosis.