Abdomino-peritoneal tuberculosis masquerading as ovarian cancer: a retrospective study of 26 cases

Sharma, Jai Bhagwan; Jain, Shreyans; Mohanraj, P.; Roy, Kallol Kumar; Malhotra, Neena; Zutshi, Vijay; Rajaram, Shalini

doi:10.1007/s00404-009-1295-6

Cited by 49 publications

(46 citation statements)

References 18 publications

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“…Peritoneal TB can be a disseminated form of TB with tubercles all over the peritoneum, intestines and omentum and may cause ascites and abdominal mass. It may masquerade as ovarian cancer as even CA 125 levels are raised in peritoneal TB with CT scan and MRI also giving similar picture and diagnosis may be made only on laparotomy done for suspected ovarian cancer [20,21]. Ascitic fluid tapping for bio-chemical analysis (elevated adenosine deaminase level in ascitic fluid in peritoneal TB) is useful in diagnosis [22].…”

Section: Etiopathogenesismentioning

confidence: 99%

“…The various signs of FGTB depend on the site of involvement of genital organs and are shown in Table 1 [5,6,8,[18][19][20][21]28].…”

Section: Clinical Featuresmentioning

confidence: 99%

“…As genital TB may manifest in different ways with no characteristic symptoms and signs, the differential diagnosis depends upon the clinical presentation and is shown in Table 2 [5,6,8,[18][19][20].…”

Section: Differential Diagnosismentioning

confidence: 99%

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Current Diagnosis and Management of Female Genital Tuberculosis

Sharma

2015

J Obstet Gynecol India

123

145

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Female genital tuberculosis (FGTB) is an important cause of significant morbidity, short-and longterm sequelae especially infertility whose incidence varies from 3 to 16 % cases in India. Mycobacterium tuberculosis is the etiological agent for tuberculosis. The fallopian tubes are involved in 90-100 % cases, endometrium is involved in 50-80 % cases, ovaries are involved in 20-30 % cases, and cervix is involved in 5-15 % cases of genital TB. Tuberculosis of vagina and vulva is rare (1-2 %). The diagnosis is made by detection of acid-fast bacilli on microscopy or culture on endometrial biopsy or on histopathological detection of epithelioid granuloma on biopsy. Polymerase chain reaction may be false positive and alone is not sufficient to make the diagnosis. Laparoscopy and hysteroscopy can diagnose genital tuberculosis by various findings. Treatment is by giving daily therapy of rifampicin (R), isoniazid (H), pyrazinamide (Z) and ethambutol (E) for 2 months followed by daily 4 month therapy of rifampicin (R) and isoniazid (H). Alternatively 2 months intensive phase of RHZE can be daily followed by alternate day combination phase (RH) of 4 months. Three weekly dosing throughout therapy (RHZE thrice weekly for 2 months followed by RH thrice weekly for 4 months) can be given as directly observed treatment short-course. Surgery is rarely required only as drainage of abscesses. There is a role of in vitro fertilization and embryo transfer in women whose fallopian tubes are damaged but endometrium is healthy. Surrogacy or adoption is needed for women whose endometrium is also damaged.

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Section: Etiopathogenesismentioning

confidence: 99%

“…The various signs of FGTB depend on the site of involvement of genital organs and are shown in Table 1 [5,6,8,[18][19][20][21]28].…”

Section: Clinical Featuresmentioning

confidence: 99%

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Current Diagnosis and Management of Female Genital Tuberculosis

Sharma

2015

J Obstet Gynecol India

123

145

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“…9,10 Although abdominopelvic TB is very rare, the physician may interpret the findings pelvic mass, ascites, and fever as a sign of genital malignancies. Also an elevated CA 125, a marker generally used for screening for genital malignancies, may also tend the physician to focus more on genital malignancies.…”

Section: Discussionmentioning

confidence: 99%

“…8 Of these, pelvic TB is relatively rare and may be misdiagnosed as genital malignancy or other pelvic diseases due to its location. 9,10 Genital TB is also a major cause of infertility in the developing countries. 11 In this case report, we discuss a renal transplant patient with pelvic pain and fever, who was later diagnosed as having multidrug-resistant abdominopelvic TB.…”

Section: Introductionmentioning

confidence: 99%

Differential Diagnosis of an Unusual Pelvic Mass in a Renal Transplant Recipient: Multidrug-Resistant Abdominopelvic Tuberculosis

et al. 2011

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Renal transplant patients are more prone to tuberculosis infection due to the underlying intense immunosuppression, with an incidence 20-74 times higher than that in the general population. It is associated with graft dysfunction and increased mortality rates. It can be frequently pulmonary but extra-pulmonary involvement is not rare, and in the latter case, it may be misinterpreted as genital malignancies. In this case report, we discuss a renal transplant patient with pelvic pain and fever, who was later diagnosed as having abdominopelvic tuberculosis.

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