Peritoneal tuberculosis with elevated serum Ca-125 level mimicking advanced stage ovarian cancer: a case report.
BACKGROUND
Tuberculosis is still a common problem in immigrant population with peritoneal tuberculosis as the most common presentation of extrapulmonary disease.


METHODS
A 36-year-old woman presented with abdominal distention, night sweats and weight loss. Physical examination and radiologic studies revealed ascites, omental caking and bilateral enlarged ovaries with an elevated serum Ca-125 of 353 U/mL. Acid-fast stain and culture were negative for Mycobacterium tuberculosis. Diagnostic laparoscopy and biopsy revealed multiple granulomas with epithelioid cells and caseification necrosis confirming tuberculosis. Treatment with anti-tuberculin drugs resulted in resolution of symptoms with a reduction in Ca-125 to normal.


CONCLUSIONS
Laparoscopic biopsy with frozen section evaluation would spare patients with peritoneal tuberculosis from unnecessary extensive surgery. Serum Ca-125 level may be useful in monitoring treatment response.
Tan
Orkun
O
Department of Obstetrics and Gynecology, New York University School of Medicine, Bellevue Hospital, New York, NY 10016, USA. tano01@med.nyu.edu
Luchansky
Edward
E
Rosenman
Stephen
S
Pua
Tarah
T
Azodi
Masoud
M
D000328:Adult; D018394:CA-125 Antigen / Q000097:blood*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D010051:Ovarian Neoplasms / Q000175:diagnosis; D014395:Peritonitis, Tuberculous / Q000097:blood / Q000175:diagnosis*
D018394:CA-125 Antigen