Genital tuberculosis can present as disseminated ovarian carcinoma with ascites and raised Ca-125: A case report

In women with an adnexal mass, ascites and elevated Ca-125 levels, ovarian carcinoma must be ruled out. However, several other conditions, including g enital tuberculosis, may present similarly. A 41-year-old woman with weight loss, ascites and elevated levels of Ca-125 was evaluated for ovarian canc er. Computerized tomography revealed an adnexal mass, ascites and lymph-nod es on the peritoneal surface. Paracentesis of the ascitic fluid revealed a lymphocytic exudate but failed to show any malignant cells. At laparotomy, frozen sections of tissue biopsies were negative for malignancy; however, a total hysterectomy plus adnexectomy was performed. Postoperatively histolo gic examination revealed typical features of genital tuberculosis. Antitube rculosis treatment was effectively given to the patient. Serum levels of Ca -125 were undetectable 12 weeks after treatment. In conclusion, genital tub erculosis can be misdiagnosed and confused with ovarian cancer. Intraperito neal tuberculosis should be considered in the differential diagnosis in cas es in which ovarian cancer is suspected, even when malignancy-associated ri sk factors are present. Copyright (C) 2001 S. Karger AG, Basel.