Diagnostic dilemma of abdominopelvic tuberculosis:a series of 20 cases.
OBJECTIVE
To establish more effective diagnostic procedures to identify the characteristic features of abdominopelvic tuberculosis (APTB) mimicking advanced ovarian cancer.


METHODS
A retrospective review of 20 cases of APTB mimicking advanced ovarian cancer was undertaken.


RESULTS
The mean age of the patients was 28.9 ± 10.8 years. The main clinical manifestations were abdominal pain (45%) and distention (45%). CA125 level was elevated in 18 cases (90.0%). Pelvic mass in 18 patients (90.0%) and ascites in 12 patients (60.0%) were detected by using abdominal US. The bacteriologic cultures and cytological studies were all negative (10 cases, 100%). Laparotomy (17 cases) and laparoscopic evaluation (1 case) was performed with the presumptive diagnosis of advanced ovarian cancer except for 2 patients treated with diagnostic anti-TB chemotherapy. The common intra-operative findings were miliary nodules (14 cases, 77.8%) and widespread adhesion (10 cases, 55.6%). Intra-operative frozen section was obtained in 10 cases, and the typical tuberculosis tubercles were detected in all cases.


CONCLUSIONS
APTB should be considered in all cases with pelvic mass, ascites and high levels of CA125, although clinical features and laboratory results specifically indicate neither ovarian malignancy nor APTB. Diagnostic laparotomy is a direct and safe method. To avoid extended surgery, the cases with APTB can be diagnosed through intra-operative frozen section in conjunction with clinical features.
Xi
Xia
X
Cancer Biology Research Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave, 430030 Wuhan, Hubei, People's Republic of China.
Shuang
Li
L
Dan
Wang
W
Ting
Hu
H
Han
Meng Yu
MY
Ying
Cao
C
Quan
Mei
M
Sun
ChaoYang
C
Chen
ZhiLan
Z
Cui
Feng
F
Ming
Cao
C
Zhou
Jian Feng
JF
Xuan
Wang Shi
WS
Lu
Yun Ping
YP
Ma
Ding
D
D000293:Adolescent; D000328:Adult; D014408:Biomarkers, Tumor / Q000097:blood; D018394:CA-125 Antigen / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood; D003937:Diagnosis, Differential; D005260:Female; D005629:Frozen Sections; D006801:Humans; D010535:Laparoscopy; D007813:Laparotomy; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000175:diagnosis*; D014395:Peritonitis, Tuberculous / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D012189:Retrospective Studies; D055815:Young Adult
D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D002272:Carcinoembryonic Antigen