Peritoneal tuberculosis mimicking ovarian cancer - diagnostic difficulties. Two cases reports

Jacek Zamłyński, Anita Olejek, Ewa Oleś, Katarzyna Stęplewska, Andrzej Krzywiecki, Grażyna Myrcik, Piotr Bodzek, Marta Paliga-Żytniewska, Alicja Gajewska

Abstract

Tuberculosis, and particularly its extrapulmonary location, still causes diagnostic difficulties. In 2007, 7.3% of newly registered
cases of tuberculosis in Poland were located extrapulmonarily. Peritoneal tuberculosis is often misdiagnosed as ovarian cancer
due to similar symptoms such as: abdominal pain, abdominopelvic masses, ascites and elevated CA-125 serum concentration.
We present reports of two patients with suspected ovarian cancer at admission. The patients’ complaints, as well as elevated
serum levels of CA-125, suggested ovarian cancer. Chest X-rays showed a normal picture in one case and minimal fibrotic
changes in the other. The results of additional tests were uncharacteristic. Based on the data obtained by diagnostic
laparoscopy, observed clinical symptoms and the intraoperative picture, which all suggested ovarian cancer, a resection (total
abdominal hysterectomy and bilateral salpingo-oophorectomy) was performed in both cases. Histological evaluation of biopsy
specimens revealed peritoneal tuberculosis in both cases.

Keywords

ovarian cancer; peritoneal tuberculosis; differential diagnosis

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