Peritoneal tuberculosis: a retrospective review of 20 cases and comparison with primary peritoneal carcinoma.
BACKGROUND
To evaluate the clinical features of peritoneal tuberculosis (TB) and to compare them with those of primary peritoneal carcinoma (PPC).


METHODS
We conducted a retrospective review of women with peritoneal TB who were managed at Samsung Medical Center from January 1996 to October 2006. As a control sample, patients with a diagnosis of PPC during the same period were also selected for comparison.


RESULTS
During the study period, we identified 20 female patients with peritoneal TB. The median age was 39 years (range, 23-69 years), and the median cancer antigen 125 (CA-125) level was 448 U/mL (range, 32-1725 U/mL). Seventeen patients with PPC whom we examined were older, with a median age of 63 years (range, 50-73 years); their median CA-125 level was higher at 1848 U/mL (range, 42-14,380 U/mL). Compared with those of PPC, the radiologic findings of peritoneal TB indicated less severe involvement of the omentum and the mesentery (P = 0.03). Among the 20 patients who underwent operations, 6 (30%) underwent exploratory laparotomy; 12 (60%), diagnostic laparoscopy; and 2 (10%), laparoscopy converted to laparotomy because of severe adhesion. Frozen tissue sections revealed chronic granulomatous tissue reaction in 15 (83.3%) of 18 women with peritoneal TB.


CONCLUSIONS
Maintaining a high index of suspicion is very important for the successful treatment of peritoneal TB, especially in developing countries. Age, CA-125 level, and omental involvement as identified by computed tomography may be helpful for the differential diagnosis of peritoneal TB and PPC.
Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Chel Hun
CH
Choi
Chul-Jung
CJ
Kim
Yoo-Young
YY
Lee
Joo Sun
JS
Kim
Taejong
T
Song
Hwang-Shin
HS
Park
Min Kyu
MK
Kim
Tae-Joong
TJ
Kim
Jeong-Won
JW
Lee
Je-Ho
JH
Lee
Duk-Soo
DS
Bae
Byoung-Gie
BG
Kim
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000175:diagnosis* / Q000601:surgery; D014395:Peritonitis, Tuberculous / Q000175:diagnosis* / Q000601:surgery; D012189:Retrospective Studies; D055815:Young Adult