Miliary tuberculous peritonitis mimicking advanced ovarian cancer.
Primary peritoneal tuberculosis is a rare presentation of this disease. It is usually associated with ascites and raised CA-125 levels. Occasionally a pelvic mass may be present making the preoperative differential diagnosis from advanced ovarian cancer extremely difficult. Acid-fast stains and special cultures of the ascitic fluid for Mycobacterium tuberculosis are frequently negative, and confirmation of the diagnosis commonly requires histologic examination of biopsy specimens, in which epithelioid granulomas with central caseous necrosis can be identified. We present a case of unexplained pyrexial ascites in a postmenopausal woman in whom the diagnosis of miliary peritoneal tuberculosis was confirmed laparoscopically. The role of noninvasive tools such as measurement of ascitic fluid adenosine deaminase levels is also discussed.
Protopapas
Athanasios
A
1st Department of Obstetrics and Gynecology, University of Athens, Hospital, Athens, Greece. protom@aias.gr
Milingos
Spiros
S
Diakomanolis
Emmanuel
E
Elsheikh
Alexander
A
Protogerou
Athanasios
A
Mavrommatis
Konstantinos
K
Michalas
Stylianos
S
D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D001201:Ascites; D003937:Diagnosis, Differential; D005260:Female; D005334:Fever; D006801:Humans; D010535:Laparoscopy; D010051:Ovarian Neoplasms; D014395:Peritonitis, Tuberculous / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D014057:Tomography, X-Ray Computed; D014391:Tuberculosis, Miliary / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D014463:Ultrasonography
D000995:Antitubercular Agents