title: Genital tuberculosis can present as disseminated ovarian carcinoma with ascites and raised Ca-125: a case report.
abstract: In women with an adnexal mass, ascites and elevated Ca-125 levels, ovarian carcinoma must be ruled out. However, several other conditions, including genital tuberculosis, may present similarly. A 41-year-old woman with weight loss, ascites and elevated levels of Ca-125 was evaluated for ovarian cancer. Computerized tomography revealed an adnexal mass, ascites and lymph nodes on the peritoneal surface. Paracentesis of the ascitic fluid revealed a lymphocytic exudate but failed to show any malignant cells. At laparotomy, frozen sections of tissue biopsies were negative for malignancy; however, a total hysterectomy plus adnexectomy was performed. Postoperatively histologic examination revealed typical features of genital tuberculosis. Antituberculosis treatment was effectively given to the patient. Serum levels of Ca-125 were undetectable 12 weeks after treatment. In conclusion, genital tuberculosis can be misdiagnosed and confused with ovarian cancer. Intraperitoneal tuberculosis should be considered in the differential diagnosis in cases in which ovarian cancer is suspected, even when malignancy-associated risk factors are present.
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital of Heraklion, and University of Crete, Heraklion, Greece. sifakis@excite.com
authors.forename: L G
authors.initials: LG
authors.lastname: Manidakis
authors.forename: E
authors.initials: E
authors.lastname: Angelakis
authors.forename: S
authors.initials: S
authors.lastname: Sifakis
authors.forename: P
authors.initials: P
authors.lastname: Stefanaki
authors.forename: A
authors.initials: A
authors.lastname: Kalogeraki
authors.forename: A
authors.initials: A
authors.lastname: Manidaki
authors.forename: E
authors.initials: E
authors.lastname: Koumantakis
mesh_terms: D015746:Abdominal Pain; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D001201:Ascites; D001202:Ascitic Fluid / Q000473:pathology; D001706:Biopsy; D018394:CA-125 Antigen / Q000097:blood*; D003937:Diagnosis, Differential; D005260:Female; D005629:Frozen Sections; D005831:Genital Diseases, Female / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D006801:Humans; D007044:Hysterectomy; D010051:Ovarian Neoplasms; D010532:Peritoneal Diseases / Q000382:microbiology; D014057:Tomography, X-Ray Computed; D014376:Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy; D015431:Weight Loss
chemical_list: D000995:Antitubercular Agents; D018394:CA-125 Antigen