Abdomino-peritoneal tuberculosis masquerading as ovarian cancer: a retrospective study of 26 cases

Arch Gynecol Obstet. 2010 Dec;282(6):643-8. doi: 10.1007/s00404-009-1295-6. Epub 2009 Dec 1.

Abstract

Purpose: Evaluation of clinical, laboratory, and operative findings in women of abdomino-pelvic tuberculosis undergoing laparotomy for suspected ovarian cancer.

Methods: A retrospective analysis of 26 women who underwent laparotomy for ovarian cancer and found to have abdomino-pelvic tuberculosis in three hospitals of Delhi.

Results: The mean age was 34.65 years. Symptoms were menstrual dysfunction in 12 (46.2%), abdominal distension (8 women, 30.7%), abdominal pain (26 women, 100%), abdominal mass (5 women, 19.2%). Mean and standard deviation (SD) of Ca-125 levels were 594.22 ± 770.07. The mean ± SD of right and left tubovarian mass being 5.82 ± 3.94 cm and 5.81 ± 3.21 cm, respectively. Abdominal hysterectomy was done in 4 (15.4%) cases, right ovariotomy in 5 (19.2%), left Ovariotomy in 6 (23.1%), biopsies from right ovary 11 (42.3%), left ovary 7 (26.9%), omentum 10 (38.5%), peritoneum in 15 (57.7%). Tuberculous granuloma and AFB stain on histopathology were observed in all cases.

Conclusion: Peritoneal tuberculosis with abdomino-pelvic masses was difficult to differentiate from ovarian cancer. Antitubercular drugs are the treatment of choice and complete surgery being difficult and hazardous should be avoided.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Diagnostic Errors*
  • Female
  • Humans
  • Laparotomy
  • Middle Aged
  • Ovarian Neoplasms / diagnosis*
  • Peritonitis, Tuberculous / diagnosis*
  • Retrospective Studies
  • Young Adult