The great imitator: miliary peritoneal tuberculosis mimicking Stage III ovarian carcinoma

Purpose: To report a case of peritoneal tubercolosis initially mistaken at the time of surgery for metastatic ovarian carcinoma. Case Report: A 31-year-old Filipino female was found to have increasing abd ominal pain, ascites, early satiety, increasing abdominal girth and bilater al complex masses. Diagnostic laparoscopy revealed the presence of > 4 lite rs of ascites, a frozen pelvis secondary to what appeared to be bilateral o varian carcinomas, along with miliary seeding of the entire anterior abdomi nal wall, omentum, small bowel and small bowel mesentery, right and left di aphragmatic surfaces, and hepatic surface. Frozen section, at the time of l aparotomy, revealed necrotizing granulomas most consistent with disseminate d tuberculosis that was confirmed at the time of final pathologic review an d culture. Conclusion: Peritoneal tuberculosis can be mistaken for widely metastatic o varian carcinoma at time of surgery.