Peritoneal tuberculosis in premenopausal patients with elevated serum CA 125.
BACKGROUND
Peritoneal tuberculosis predominantly involves the omentum, intestinal tract, liver, spleen, and genitourinary tract and occurs in 1-4% of patients with pulmonary tuberculosis. Peritoneal tuberculosis may mimic a pelvic mass in imaging studies and also may increase CA-125 levels. Peritoneal tuberculosis may also produce massive ascites, and intraperitoneal gross appearance might be similar to the peritoneal carcinomatosis. Therefore, peritoneal tuberculosis is often confused with advanced-stage epithelial carcinoma because of similar clinical, radiologic, and laboratory findings and later intraoperative findings.


METHODS
The pathology records between January 2000 and August 2008 were retrospectively reviewed at 19 Mayis University Hospital. Twenty-two patients were found to have peritoneal caseating necrosis. A total of 13 out of 22 patients were found to have high CA 125 level.


RESULTS
Among these 13 patients, 8 patients received/are receiving anti-tuberculous therapy after they were incidentally diagnosed with peritoneal tuberculosis.


CONCLUSIONS
Increased CA 125 levels should be evaluated carefully prior to aggressive surgical approach, especially in premenopausal women and frozen section evaluation should be done before extensive surgical procedure if there is any suspicion.
Ulusoy
Ali Naki
AN
Department of General Surgery, 19 Mayis University Medical Faculty, Samsun, Turkey.
Karabicak
Ilhan
I
Dicle
Kadir
K
Kefeli
Mehmet
M
Tosun
Migraci
M
Cetinkaya
Mehmet
M
Alper
Tayfun
T
Ustun
Cazip
C
D000328:Adult; D018394:CA-125 Antigen / Q000097:blood*; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008875:Middle Aged; D014395:Peritonitis, Tuberculous / Q000097:blood* / Q000175:diagnosis; D017697:Premenopause / Q000097:blood; D012189:Retrospective Studies
D018394:CA-125 Antigen