Peritoneal tuberculosis mimicking ovarian cancer

Year 2012, Volume: 29 Issue: 1, 58 - 60, 17.04.2012

Emel Kurtoğlu , Yeşim Gürel

https://doi.org/10.5835/jecm.omu.29.01.014

Abstract

Peritoneal tuberculosis is a frequent form of abdominal tuberculosis. As clinical and laboratory findings mimicking many other abdominal pathologies, especially ovarian cancer, differential diagnosis is difficult. Here, we report a woman presented with abdominal pain in her lower abdominal quadrant. There were uncertain bordered bilateral adnexial masses, ascite, peritoneal nodular thickening and lytic lesion with soft tissue component at 11th thoracal vertebra at computed tomography. CA 125 level was 445.7 U/ml and positron emission tomography was resulted in favour of metastasis for lesion at thoracal vertebra. The patient underwent expletory laparotomy with suspicion of ovarian cancer but peritoneal biopsy taken from nodular lesions was reported as caseating granulomatous inflammation in favour of peritoneal tuberculosis. As differentiation between tuberculosis and malignancy is too difficult, these two possibilities should be part of the differential diagnosis.

Keywords

Peritoneal tuberculosis, Ovarian cancer, CA 125, Ascite, Caseating granulomatous infl ammation, Adnexial mass

References

• Barutcu, O., Erel, H.E., Saygili, E., Yildirim, T., Torun, D., 2002. Abdominopelvic tuberculosis stimulating disseminated ovarian carsinoma with elevatde C.A. 125 level: Report of two cases. Abdom. Imaging. 27, 465-470.
• Corapcioglu, F., Guvenc, B.H., Sarper, N., Aydogan, A., Akansel, G., Arisoy, E.S., 2006. Peritoneal tuberculosis with elevated serum C.A. 125 level mimicking advanced ovarian carcinoma in an adolescent. Turk. J. Pediatr. 48, 69-72.
• Julien, T.M.Y., Friedman, S.L., McQuaid, K.R., Grendel, J.H., 2003. Miscallaneous diseases of the peritoneum&mesentery. Ineds. Current diagnosis and treatment in gastroenterology 2 nd edition New York: McGraw-Hill Companies. 166-173.
• Jurcut, C., Filisan, C., Popovici, C., Toma, L., Panaite, B., Nicodin, O., Copaci, I., 2009. Young woman with polyserositis, ovarian cystic mass and increased level of C.A.125. Case report of peritoneal and pleural tuberculosis. Rom. J. Intern. Med. 47, 297-299.
• Kawatra, V., Kohli, K., Khurana, N., 2010. Pelvic tuberculosis mimicking ovarian malignancy: A case report J. Reprod. Med. 55, 449-451.
• Koc, S., Beydilli, G., Tulunay, G., 2006. Peritoneal tuberculosis mimicking advanced ovarian cancer: A retrospective review of 22 cases. Gy- necol. Oncol. 103, 565-569.
• Lantheaume, S., Soler, S., Issartel, B., 2003. Peritoneal tuberculosis stimulating advanced ovarian carcinoma: A case report. Gynecol. Obstet. Fertil. 31, 624-626.
• Li, X.J., Wu, L.Y., Li, X.G., Sun, Y.C., 2003. Analysis of 20 cases of pelvic tuberculosis initially suspected of ovarian carcinoma Zhonghua Jie He He Hu Xi Za Zhi. 26, 462-464.
• Panoskaltsis, T.A., Moore, D.A., Haidopoulos, D.A., Mc Indoe, A.G., 2000. Tuberculous peritonitis: Part of differential diagnosis in ovarian cancer. Am. J. Obstet. Gynecol. 182, 740-742.
• Piura, B., Rabinovich, A., Leron, E., Yanai-Inbar, I., Mazor, M., 2002. Peritoneal tuberculosis mimicking ovarian carcinoma with ascites and elevated serum C.A. 125: Case report and review of literature. Eur. J. Obstet. Gynecol. 23, 120-122.
• Sharma, J.B., Jain, S.K., Pushpraj, M., Roy, K.K., Malhotra, N., Zutshi, V., Rajaram, S., 2010. Abdomino-peritoneal tuberculosis masquerading as ovarian cancer: A retrospective study of 26 cases. Arch. Gynecol. Obstet. 282, 643-648.
• Sheth, S.S., 1996. Elevated C.A. 125 in advanced abdominal or pelvic tuberculosis. Int. J. Obstet. Gynecol. 52, 167-171.
• Thakur, V., Mukherjee, U., Kumar, K., 2001. Elevated serum cancer antigen 125 levels in advanced abdominal tuberculosis. Med. Oncol. 18, 289-291.
• Uzunkoy, A., Harma, M., 2004. Diagnosis of abdominal tuberculosis: Experiences from 11 cases and review of the literature. World J. Gastro- enterol. 10, 3647-3649.
• Uzunkoy, A., Nazligul, Y., 2006. Peritoneal tubercuolsis : Review. Turkiye Klinikleri J. Med. Sci. 26, 404-408.