Elevated CA-125 in disseminated tuberculosis: a case report

Kulshreshtha, Dinkar; Raj, Gaurav; Singh, Sumit; Maurya, Pradeep Kumar; Singh, Anirudh; Thacker, Anup Kumar

doi:10.1093/qjmed/hcu223

Cited by 4 publications

(8 citation statements)

References 3 publications

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“…However, there are cases where raised CA-125 levels did not necessarily indicate ovarian cancer. 3 Unlike many other FG-TB cases, our patient did not exhibit menstrual symptoms, despite having endometrial TB. This deviation from the typical presentation seen in other studies highlights the variability and challenges in diagnosing FG-TB.…”

Section: Discussioncontrasting

confidence: 50%

“…As it was the case in our patient, patients with ovarian TB may present with elevated levels of CA-125, a marker for ovarian cancer. 3 When patients delay in seeking health care and thus present as an acute abdomen emergency condition, the situation may further pose a significant challenge in diagnosing FG-TB, as evidenced by our case which was initially thought to have ovarian cancer clinically. This scenario is not uncommon, as numerous studies have reported similar phenomenon.…”

Section: Discussionmentioning

confidence: 88%

“…Similarly, pelvic pain, infertility, fever, unusual uterine hemorrhage, ascites, and pelvic mass have been reported in patients with FG-TB. [3][4][5][6] A tumor marker for ovarian cancer (cancer antigen-125 [CA-125]) may also rise in TB patients, although a pelvic mass with ascites, elevated CA-125 levels, and peritoneal seeding strongly suggest pelvic cancers.…”

Section: Introductionmentioning

confidence: 99%

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The haunting diagnosis of malignancy in women with treatable reproductive system tuberculosis

Mremi,

Pyuza,

Amsi

et al. 2023

SAGE Open Medical Case Reports

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This study reports a case of female genital tuberculosis in a 46-year-old woman who presented to emergency department with abdominal pain and progressive abdominal distension. The patient was initially thought to have ovarian cancer based on clinical diagnosis and elevated cancer antigen-125 (CA-125) levels. Intra-operatively, no obvious ovarian tumor was encountered instead; disseminated creamy white patches on the uterus and left adnexa were seen. About 4500-mL straw-colored ascitic fluid and disseminated creamy white patches were also found on the bowels and omentum giving an impression of carcinomatosis. However, histopathology of the fallopian tube and ovary confirmed the diagnosis of female genital tuberculosis as the underlying cause. Female genital tuberculosis often mimics tumors in its clinical appearance and symptoms, leading to misdiagnosis and unnecessary treatment. The key to diagnosing female genital tuberculosis is being suspicious as it is challenging to diagnose through laboratory tests or radiology. The mainstay of treatment for female genital tuberculosis is a combination of four antituberculosis drugs. Consideration of female genital tuberculosis as a differential diagnosis in women presenting with symptoms mimicking reproductive tumors is highly recommended as highlighted in this case report.

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Section: Discussioncontrasting

confidence: 50%

Section: Discussionmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

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The haunting diagnosis of malignancy in women with treatable reproductive system tuberculosis

Mremi,

Pyuza,

Amsi

et al. 2023

SAGE Open Medical Case Reports

View full text Add to dashboard Cite

show abstract

“…Five cases TB were treated empirically without initial microbiological evidence (3,5,9,14,15). Our review (4,(16)(17)(18)(19)(20)(21) found that the majority of cases (35%) diagnosed disseminated tuberculosis from a biopsy (7/20). Indonesia's National Tuberculosis Control Program, which was adopted from the WHO tuberculosis treatment guidelines, recommends that subject with a negative AFB but with clinical symptoms and a chest X-ray that is suggestive of TB, should be treated for tuberculosis smear-negative with further mycobacteria culture confirmation.…”

Section: Discussionmentioning

confidence: 90%

Massive Disseminated Tuberculosis in an Immunocompetent Patient: Early Diagnostic and Empiric Treatment Approach from an Endemic Country: Indonesia (A Case Report and Literature Review)

Widysanto¹,

Soetjipto²,

Lugito³

2019

Respir Case Rep

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Tuberculosis is still rampant, despite the centuries of efforts to conquer it. Indonesia is host to the third highest TB burden in the world, with an uneven distribution of health care access, and especially to highly sensitive and specific molecular investigations. Rapid and accurate TB diagnosis is crucial for the control of the infection. An AFB smear test is easily accessed and is cost-effective, although there are a number of shortcomings with the approach. We report here on a case of negative acid-fast bacilli (AFB) smear disseminated tuberculosis (TB) in a previously healthy 23year-old Indonesian female who presented to a secondary care facility with pulmonary, pericardial, peritoneal, utero-ovarian, genitourinary and splenic involvement. The clinician chose to start antituberculosis therapy without a positive microbiology and biopsy for bacterial load containment purposes, considering also the patient's clinical and endemic epidemiology. The diagnosis was confirmed with a positive mycobacterial culture after the initiation of anti-tuberculosis therapy. In the present study, we also review the diagnosis of 20 other cases of disseminated tuberculosis reported in other countries.

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“…Se ha demostrado que los valores superiores a 1 000 UI/mL se correlacionan con malignidad (13) . Sin embargo, existen reportes de casos de tuberculosis peritoneal con concentraciones superiores de 1 081 UI/mL (14) . Esto significa que las concentraciones absolutas de CA-125 no son definitivas para determinar la presencia de lesiones malignas.…”

Section: Reporte De Casounclassified

Tuberculosis peritoneal simulando carcinoma de ovario

Carvallo-Tapia¹,

Torres-Cepeda²

2017

Rev peru ginecol obstet.

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La tuberculosis peritoneal es una ubicación extrapulmonar común en mujeres, con características similares a neoplasias malignas ováricas avanzadas. Es difícil de diagnosticar debido a que produce ascitis masiva y crecimiento peritoneal marcado, similar a la carcinomatosis. Se necesitan estudios patológicos y cultivos bacterianos para confirmarlo, ya que no existen hallazgos clínicos, de laboratorio o radiológicos patognomónicos para la patología. El tratamiento temprano generalmente tiene un buen pronóstico. Se presenta un caso de tuberculosis peritoneal con la triada clásica (ascitis similar a carcinoma ovárico en etapas avanzadas, tumores abdominopélvicos y aumento de las concentraciones séricas de CA-125). La laparotomía mostró nódulos abdominales-peritoneales con inflamación granulomatosa. La paciente inició tratamiento y, durante el seguimiento, los síntomas al igual que las concentraciones de CA-125 normalizaron.

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Elevated CA-125 in disseminated tuberculosis: a case report

Cited by 4 publications

References 3 publications

The haunting diagnosis of malignancy in women with treatable reproductive system tuberculosis

The haunting diagnosis of malignancy in women with treatable reproductive system tuberculosis

Massive Disseminated Tuberculosis in an Immunocompetent Patient: Early Diagnostic and Empiric Treatment Approach from an Endemic Country: Indonesia (A Case Report and Literature Review)

Tuberculosis peritoneal simulando carcinoma de ovario

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