title: Peritoneal tuberculosis mimicking advanced ovarian cancer: a retrospective review of 22 cases.
abstract: OBJECTIVE
  To evaluate the clinical, laboratory and diagnostic features in women with peritoneal tuberculosis that resembled advanced ovarian malignancy.
  
  
  METHODS
  A retrospective review of women with peritoneal tuberculosis who were managed at TCSB Ankara Etlik Maternity and Women's Health Teaching and Research Hospital from July 1992 to November 2004 was undertaken.
  
  
  RESULTS
  Among the 1,826 women treated during the study period, 22 women with peritoneal tuberculosis (1.2%) were identified. The mean age was 36.9 years (range 21-68 years); the mean Ca125 level was 564.95 U/ml (3-2021 U/ml). All patients with peritoneal tuberculosis had ascites, 20 patients (90.91%) had elevated CA125 levels and 17 patients (77.27%) had detectable pelvic masses in the preoperative period. During preoperative diagnostic work-up, pulmonary tuberculosis was diagnosed and antituberculosis therapy had begun in two of 22 patients (9.09%). Among 20 patients, 11 (55%), 8 (40%) and 1 (5%) underwent exploratory laparotomy, diagnostic laparoscopy and laparoscopy converted to laparotomy due to dense pelvic adhesions, respectively. Since frozen section was not available during the surgery in 5 of 20, 3 patients (10%) underwent extended surgery. Frozen section was performed in 15 patients and revealed chronic granulomatous changes and final pathological examination confirmed the diagnosis.
  
  
  CONCLUSIONS
  Our data indicate that the majority of the cases with peritoneal tuberculosis can be diagnosed intraoperatively through the use of frozen section in conjunction with clinical features. Ascites and high levels of Ca125 do not necessarily indicate that the clinical picture is malignant in reproductive women. Laparoscopic tissue biopsy may be a fundamental tool in the management of such cases to avoid extended surgery.
authors.affiliation: TCSB Ankara Etlik Maternity and Women's Health Teaching and Research Hospital, Ankara, Turkey. zeynepsu409@yahoo.com
authors.forename: Sevgi
authors.initials: S
authors.lastname: Koc
authors.forename: Gulay
authors.initials: G
authors.lastname: Beydilli
authors.forename: Gokhan
authors.initials: G
authors.lastname: Tulunay
authors.forename: Reyhan
authors.initials: R
authors.lastname: Ocalan
authors.forename: Nurettin
authors.initials: N
authors.lastname: Boran
authors.forename: Nejat
authors.initials: N
authors.lastname: Ozgul
authors.forename: M Faruk
authors.initials: MF
authors.lastname: Kose
authors.forename: Zuhal
authors.initials: Z
authors.lastname: Erdogan
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D018394:CA-125 Antigen / Q000097:blood; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D014395:Peritonitis, Tuberculous / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
chemical_list: D018394:CA-125 Antigen