Peritoneal Tuberculosis Mimicking Ovarian Cancer: A Report of Two Cases

Abstract

Introduction: Peritoneal tuberculosis (PTB) and ovarian cancer have overlapping nonspecific symptoms and signs. No pathog- nomonic clinical features or imaging findings can help to distinguish definite diagnosis of extra pulmonary TB. Peritoneal TB can be easily confused with peritoneal carcinomatosis or advanced ovarian carcinoma; therefore, it is dicult to distinguish these two entities. The current study described two cases of peritoneal tuberculosis mimicking advanced ovarian cancer. Case Presentation: In the first case, the initial manifestation was lower abdominal pain. The imaging indicated ovarian mass, as- cites and hepatic surface nodularity, omental and peritoneal thickening. Also, titer of tumor marker CA-125 was more than 600 units. In laparoscopy, disseminated peritoneal seeding was observed. Frozen section of sampling these lesions reported tubercu- losis. Biopsy of ovarian mass reported fibrothecoma. Concurrent with this patient, the second case referred to the same center, Department of Gynecology Oncology at Ghaem Hospital, Mashhad University, Iran, in 2015. Her presentation was fever and remark- able weight loss during the last three months. She had a multiloculated pelvic mass with septation in sonography and peritoneal seeding with pleural eusion in computed tomography (CT) scan. Peritoneal tuberculosis was recognized through laparotomy and both patients received anti-TB treatment and now they are in good health status. Conclusions: Peritoneal tuberculosis should always be considered in dierential diagnosis of patients with evidences suggesting