title: Peritoneal tuberculosis with elevated serum Ca-125 level mimicking advanced stage ovarian cancer: a case report.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, New York University School of Medicine, Bellevue Hospital, New York, NY 10016, USA. tano01@med.nyu.edu
authors.forename: Orkun
authors.initials: O
authors.lastname: Tan
authors.forename: Edward
authors.initials: E
authors.lastname: Luchansky
authors.forename: Stephen
authors.initials: S
authors.lastname: Rosenman
authors.forename: Tarah
authors.initials: T
authors.lastname: Pua
authors.forename: Masoud
authors.initials: M
authors.lastname: Azodi
mesh_terms: 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*
chemical_list: D018394:CA-125 Antigen