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

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

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.

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References

  1. World Health Organization (1994) WHO report on the TB epidemic: TB a global emergency? WHO/TB/94.177. World Health Organization, Geneva

  2. Dye C, Watt CJ, Bleed DM, Hosseini SM, Raviglione MC (2005) Evolution of tuberculosis control and prospects for reducing tuberculosis incidence, prevalence and deaths globally. JAMA 293:2790–2793

    Article  Google Scholar 

  3. World Health Organization (2006) Global tuberculosis control: surveillance, planning, financing. World Health Organization, Geneva, Switzerland, WHO/HTM/TB 2006, p 362

  4. TB India (2006) Revised National Tuberculosis control Programme (RNTCP) status report. Central TB division, directorate General of Health Services. Ministry of Health and family Welfare. Nirman Bhavan, New Delhi, India. http://www.tbcindia.org

  5. Koc S, Beydilli G, Tulunay G, Ocalan R, Boran N, Ozgul N, Kose MF, Erdogan Z (2006) Peritoneal tuberculosis mimicking advanced ovarian cancer: a retrospective review of 22 cases. Gynecol Oncol 103(2):565–569

    Article  PubMed  Google Scholar 

  6. Demir K, Okten A, Kaymakoğlu S et al (2001) Tuberculous peritonitis-reports of 26 cases, detailing diagnostic and therapeutic problems. Eur J Gastroenterol Hepatol 13:581–585

    Article  CAS  PubMed  Google Scholar 

  7. Panoskaltsis TA, Moore DA, Haidopoulos DA, McIndoe AG (2000) Tuberculous peritonitis; part of the differential diagnosis in ovarian cancer. Am J Obstet Gynecol 182:740

    Article  CAS  PubMed  Google Scholar 

  8. Wu JF, Li HJ, Lee PI, Ni YH, Yu SC, Chang MH (2003) Tuberculous peritonitis mimicking peritonitis carcinomatosis: a case report. Eur J Pediatr 162:853–855

    Article  PubMed  Google Scholar 

  9. Mahdavi A, Malviya VK, Hershman BR (2002) Case report: peritoneal tuberculosis disguised as ovarian cancer: an emerging clinical challenge. Gynecol Oncol 84:167–170

    Article  PubMed  Google Scholar 

  10. Piura B, Rabinovich A, Leron E, Yanai-Inbar I, Mazor M (2002) Peritoneal tuberculosis mimicking ovarian carcinoma with ascites and elevated serum Ca-125: case report and review of literature. Eur J Gynaecol Oncol 23:120–122

    CAS  PubMed  Google Scholar 

  11. Straughn JM, Robertson MW, Partridge EE (2000) A patient presenting with pelvic mass, elevated Ca-125, and fever. Gynecol Oncol 77:471–472

    Article  CAS  PubMed  Google Scholar 

  12. Penna L, Manyonda Y, Amias A (1993) Intraabdominal miliary tuberculosis presenting as disseminated ovarian carcinoma with ascites and raised CA-125. Br J Obstet Gynaecol 100:51–53

    Google Scholar 

  13. Hopewell PC (1994) Overview of clinical tuberculosis. In: Bloom BR (ed) Tuberculosis, pathogenesis, protection and control, 1st edn, chap 3. American Society for Microbiology, Washington, DC, pp 25–46

  14. Akhan O, Pringot J (2002) Imaging of abdominal tuberculosis. Eur Radiol 12:312–323

    Article  PubMed  Google Scholar 

  15. Marshall JB (1993) Tuberculosis of the gastrointestinal tract and peritoneum. Am J Gastroenterol 88:989–999

    CAS  PubMed  Google Scholar 

  16. Sharma JB, Sharma S, Gupta S, Gulati N, Banga G (1990) Bilateral serous cystadenocarcinoma of ovary with associated endometrial tuberculosis. J Obstet Gynaecol India 40:613–614

    Google Scholar 

  17. Sharma JB, Malhotra M, Pundir P, Arora R (2001) Cervical tuberculosis masquerading as cervical carcinoma: a rare case. J Obstet Gynaecol India 51:184

    Google Scholar 

  18. Sharma JB (2008) Tuberculosis and obstetric and gynecological practice. In: Stud J, Tan SL, Chervena FA (eds) Progress in Obstetrics and Gynecology, 18th edn. Elsevier, Edinburgh, pp 395–427

    Google Scholar 

  19. Bastani B, Shariatzadeh MR, Dehdasthi F (1985) Tuberculous peritonitis—report of 30 cases and review of the literature. Q J Med 56:549–557

    CAS  PubMed  Google Scholar 

  20. Lewis S, Field S (1996) Intestinal and peritoneal tuberculosis. In: Rom WN, Garay SM (eds) Tuberculosis. Little, Brown and Co, New York, pp 585–597

    Google Scholar 

  21. Vyrasvanathan S, Jeyarajah R (1980) Tuberculous peritonitis: a review of thirty-five cases. Postgrad Med J 56:649–651

    Article  Google Scholar 

  22. Sharma JB, Pushparaj M, Roy KK, Neyaz Z, Gupta N, Kumar S, Mittal S (2008) Hysterosalpingographic findings in infertility with genital tuberculosis. Int J Gynecol Obstet 101(2):150–155

    Article  Google Scholar 

  23. Sharma JB, Roy KK, Pushparaj M, Kumar S (2009) Hysteroscopic findings in women with primary and secondary infertility due to genital tuberculosis. Int J Gynaecol Obstet 104(1):49–52

    Article  PubMed  Google Scholar 

  24. Sharma JB, Roy KK, Pushparaj M, Kumar S, Malhotra N, Mittal S (2008) Laparoscopic findings in female genital tuberculosis. Arch Gynecol Obstet 278(4):359–364

    Article  PubMed  Google Scholar 

  25. Krishnan P, Vayoth SO, Dhar P, Surendran S, Ponnambathyayil S (2008) Laparoscopy in suspected abdominal tuberculosis is useful as an early diagnostic method. ANZ J Surg 78(11):987–989

    Google Scholar 

  26. Târcoveanu E, Dimofte G, Bradea C, Lupaşcu C, Moldovanu R, Vasilescu A (2009) Peritoneal tuberculosis in laparoscopic era. Acta Chir Belg 109(1):65–70

    PubMed  Google Scholar 

  27. Jeffry L, Kerrou K, Camatte S, Lelievre L, Metzger U, Robin F et al (2003) Peritoneal tuberculosis revealed by carcinomatosis on CT scan and uptake at FDG-PET. Br J Obstet Gynaecol 110:1129–1131

    Google Scholar 

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The authors guarantee that this article has not been published elsewhere; it is not being considered for publication elsewhere; and that it has been submitted with the full knowledge and approval of the institution or organization given as the affiliation of the authors.

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Correspondence to Jai Bhagwan Sharma.

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Sharma, J.B., Jain, S.K., Pushparaj, M. et al. Abdomino-peritoneal tuberculosis masquerading as ovarian cancer: a retrospective study of 26 cases. Arch Gynecol Obstet 282, 643–648 (2010). https://doi.org/10.1007/s00404-009-1295-6

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  • DOI: https://doi.org/10.1007/s00404-009-1295-6

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