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Diagnostic dilemma of abdominopelvic tuberculosis:a series of 20 cases

Journal of Cancer Research and Clinical Oncology volume 136, pages 1839–1844 (2010)Cite this article

Abstract

Objective

To establish more effective diagnostic procedures to identify the characteristic features of abdominopelvic tuberculosis (APTB) mimicking advanced ovarian cancer.

Methods

A retrospective review of 20 cases of APTB mimicking advanced ovarian cancer was undertaken.

Results

The mean age of the patients was 28.9 ± 10.8 years. The main clinical manifestations were abdominal pain (45%) and distention (45%). CA125 level was elevated in 18 cases (90.0%). Pelvic mass in 18 patients (90.0%) and ascites in 12 patients (60.0%) were detected by using abdominal US. The bacteriologic cultures and cytological studies were all negative (10 cases, 100%). Laparotomy (17 cases) and laparoscopic evaluation (1 case) was performed with the presumptive diagnosis of advanced ovarian cancer except for 2 patients treated with diagnostic anti-TB chemotherapy. The common intra-operative findings were miliary nodules (14 cases, 77.8%) and widespread adhesion (10 cases, 55.6%). Intra-operative frozen section was obtained in 10 cases, and the typical tuberculosis tubercles were detected in all cases.

Conclusion

APTB should be considered in all cases with pelvic mass, ascites and high levels of CA125, although clinical features and laboratory results specifically indicate neither ovarian malignancy nor APTB. Diagnostic laparotomy is a direct and safe method. To avoid extended surgery, the cases with APTB can be diagnosed through intra-operative frozen section in conjunction with clinical features.

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Acknowledgments

This project was supported by grants from National “973”Key Basic Research and Development Program Foundation (No. 2009CB521808) and National Science Foundation of China (No. 30628029; 30672227; 30528012, 30600667).

Conflict of interest statement

None declared.

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Affiliations

  1. Cancer Biology Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave., 430030, Wuhan, Hubei, People’s Republic of China

    Xia Xi, Li Shuang, Wang Dan, Hu Ting, Meng Yu Han, Cao Ying, Mei Quan, Sun ChaoYang, Chen ZhiLan, Feng Cui, Cao Ming, Jian Feng Zhou, Wang Shi Xuan, Yun Ping Lu & Ding Ma

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  1. Xia Xi
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  2. Li Shuang
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  3. Wang Dan
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  4. Hu Ting
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  5. Meng Yu Han
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  7. Mei Quan
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  13. Wang Shi Xuan
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  14. Yun Ping Lu
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  15. Ding Ma
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Correspondence to Ding Ma.

Additional information

X. Xi and L. Shuang contributed equally to this manuscript.

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Xi, X., Shuang, L., Dan, W. et al. Diagnostic dilemma of abdominopelvic tuberculosis:a series of 20 cases. J Cancer Res Clin Oncol 136, 1839–1844 (2010). https://doi.org/10.1007/s00432-010-0842-7

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  • DOI: https://doi.org/10.1007/s00432-010-0842-7

Keywords

  • Abdominopelvic tuberculosis
  • Ovarian cancer
  • Diagnosis
  • Laparotomy
  • Frozen section