Peritoneal tuberculosis simulating advanced ovarian carcinoma: a case report

Disseminated peritoneal tuberculosis accounts for 1–3% of tuberculosis disease, represented by high frequency of lung defects in endemic countries. The authors report one case in a 43-year-old woman, the initial interpretation of which, based on pleural and peritoneal exudate, showed suspected latero-uterine mass and significant elevated serum CA 125 level, mimicking disseminated ovarian carcinoma. Only after exploring laparotomy with biopsy was disseminated peritoneal tuberculosis identified, thus correcting the diagnosis. Symptomatology, X–ray defect, and cynetic of serum CA 125 level were left in totality after 3 months of antituberculosis multidrugs. This is a diagnostic trap, which presents a new interest for such pathology as tuberculosis, which is on the increase again in the West. [Copyright &y& Elsevier]

La tuberculose pe´ritone´ale disse´mine´e repre´sente 1 a` 3 % des manifestations tuberculeuses, domine´es par l’atteinte pulmonaire, dans les pays d’ende´mie. Les auteurs rapportent le cas d’une femme de 43 ans pre´sentant initialement un tableau de carcinose pe´ritone´ale simulant un cancer ovarien avec masse suspecte late´ro-ute´rine droite, e´panchement pleurope´ritone´al et e´le´vation marque´e du CA 125. Le diagnostic de tuberculose pe´ritone´ale disse´mine´e n’a e´te´ porte´ re´trospectivement qu’apre`s laparotomie et examen anatomopathologique. La symptomatologie, les le´sions radiologiques scanographiques ainsi que le taux se´rique du CA 125 ont re´gresse´ en totalite´ apre`s 3 mois de quadrithe´rapie anti-tuberculeuse. Il s’agit d’un diagnostic « pie`ge », pre´sentant un regain d’inte´reˆt pour une pathologie telle que la tuberculose en recrudescence sous nos latitudes. [Copyright 2003 Elsevier]