title: Coccidioidomycosis mimicking ovarian cancer.
abstract: BACKGROUND
  Dissemination of coccidioidomycosis to the abdominal cavity is rare. No previous case of peritoneal coccidioidomycosis has presented as an adnexal mass.
  
  
  METHODS
  We report a case of peritoneal coccidioidomycosis mimicking ovarian carcinoma. The patient presented with a complex ovarian mass, ascites, omental caking, and an elevated CA 125. The ultimate diagnosis was not made until frozen section histopathology was performed at staging laparotomy.
  
  
  CONCLUSIONS
  Peritoneal coccidioidomycosis can present with the clinical, radiographic, and serologic features of ovarian cancer. Although essential for diagnosis and staging, radiographic studies and tumor markers have limited specificity. Coccidioidomycosis now joins other benign conditions that comprise the differential diagnosis of patients who present with what seems to be advanced ovarian carcinoma. Infectious diseases consultation is recommended for the management of peritoneal coccidioidomycosis.
authors.affiliation: Department of Medicine, Brooke Army Medical Center, Fort Sam Houston, Texas, USA. Michael.Ellis2@cen.amedd.army.mil
authors.forename: Michael W
authors.initials: MW
authors.lastname: Ellis
authors.forename: David P
authors.initials: DP
authors.lastname: Dooley
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Sundborg
authors.forename: Laura L
authors.initials: LL
authors.lastname: Joiner
authors.forename: Edward R
authors.initials: ER
authors.lastname: Kost
mesh_terms: D000328:Adult; D001707:Biopsy, Needle; D003047:Coccidioidomycosis / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D016469:Fungemia / Q000175:diagnosis*; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D007150:Immunohistochemistry; D007813:Laparotomy / Q000379:methods; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D010052:Ovariectomy / Q000379:methods; D010532:Peritoneal Diseases / Q000175:diagnosis* / Q000382:microbiology; D018570:Risk Assessment; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome