ABDOMINOPELVIC TUBERCULOSIS MIMICKING OVARIAN CARCINOMA: A CASE REPORT

Tuberculosis (TB) is a curable infective disease,when located in the abdominopelvic region may mimic an advanced carcinomatosis. Symptoms of abdominopelvic TB are non-specific and the diagnosis is difficult because most of the patients have normal chest X-rays and elevated levels of CA125.Here a 26-year-old woman is presented who was admitted to the hospital because of low grade fever, vague abdominal pain and significant weight loss from 3 months ago. She was living in Baloochestanstate and had two healthy 4 and 6-year-old children.There was no previous history of tuberculosis in her family. Abdominal CT scan revealed bilateral enhancing adnexal masses, ascites, and omental and peritoneal thickening. Elevated serum CA-125 levels lead the diagnosis of disseminated ovarian cancer. A more careful study by transvaginal ultrasound showed bilateral severe hydropyosalpinx instead of solid ovarian masses associated with severe ascites and peritoneal thickening. Tuberculosis was suggested by this exam for the first time.Laparoscopy revealed tubercles on the peritonealsurface which was positive for TB in culture and thepatient was treated with anti-tuberculosis drugs.Patients with an abdominopelvic mass, with or without ascites, with a high serum CA125, should always raise suspicion of TB and a diagnostic laparoscopy should be performed to confirm it, especially in young and infertile women of endemic areas.