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DOI: 10.1055/s-0041-1736030
Clinical and Laboratory Characteristics of Patients with Peritoneal Tuberculosis Mimicking Advanced Ovarian Cancer
Funding There was no funding for this study.![](https://www.thieme-connect.de/media/10.1055-s-00049561/202102/lookinside/thumbnails/10-1055-s-0041-1736030-1.jpg)
Abstract
Objectives Peritoneal tuberculosis can mimic advanced abdominal malignancy. We describe clinical and laboratory characteristics in a series of female patients with peritoneal tuberculosis who were referred to a tertiary cancer center with a diagnosis of suspected advanced ovarian/primary peritoneal cancer.
Materials and Methods Details of clinical features, laboratory results including serum tumor markers, radiological findings, and ascitic fluid evaluation were retrospectively collected from hospital records for patients diagnosed to have peritoneal tuberculosis and reported descriptively.
Statistical Analysis Descriptive statistics was performed using SPSS Statistics for Windows software, version 20.0 (SPSS, Chicago, Illinois).
Results Between January 2009 and December 2017, 120 patients of peritoneal tuberculosis with a median age 41 years (range, 15–79 years) were identified. Of these 112 (93.3%; 95% CI 88.9–97.8%) patients had ascites and 63 (52.5%; 95% CI 43.6–61.4%) had adnexal mass at presentation. Mean serum cancer antigen 125 (CA-125) level was 666.9 (range, 38–18,554) U/mL. Ascitic fluid was negative for malignant cells in all patients and lymphocyte rich exudate was seen in 103 (91.9%; 86.9–97.0%) patients. Ascitic fluid adenosine deaminase (ADA) level was more than 40 U/L in 107 (95.5%; 95% CI 91.7–99.4%). Ascitic fluid Ziel–Neelsen staining was positive in 4/62 (6.5%; 95% CI 0.3–12.6%) patients while ascitic fluid culture examination for mycobacterium tuberculosis was positive in 7/59 (11.9%; 95% CI 3.6–20.1%) patients. The diagnosis of tuberculosis was based on image-guided biopsy in 44 (36.7%) patients, surgical biopsy in 8 (6.7%) patients, and a combination of clinicoradiological and laboratory features in 68 (56.7%) patients. All patients received standard antitubercular treatment.
Conclusions The study results suggest that peritoneal tuberculosis has clinical, radiological, and serological profile which may mimic advanced ovarian/primary peritoneal cancer. Peritoneal tuberculosis should be considered in the differential diagnosis of advanced abdominal malignancy.
Publikationsverlauf
Artikel online veröffentlicht:
30. September 2021
© 2021. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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References
- 1 Hopewell PC. Overview of clinical tuberculosis. In: Bloom BR, ed. Tuberculosis, Pathogenesis, Protection and Control. 1st ed. Washington, DC: American Society for Microbiology 1994: 25-46
- 2 Sinan T, Sheikh M, Ramadan S, Sahwney S, Behbehani A. CT features in abdominal tuberculosis: 20 years experience. BMC Med Imaging 2002; 2 (01) 3
- 3 Koc S, Beydilli G, Tulunay G. et al. Peritoneal tuberculosis mimicking advanced ovarian cancer: a retrospective review of 22 cases. Gynecol Oncol 2006; 103 (02) 565-569
- 4 Liu Q, Zhang Q, Guan Q, Xu JF, Shi QL. Abdominopelvic tuberculosis mimicking advanced ovarian cancer and pelvic inflammatory disease: a series of 28 female cases. Arch Gynecol Obstet 2014; 289 (03) 623-629
- 5 Hu M-L, Lee C-H, Kuo C-M. et al. Abdominal tuberculosis: analysis of clinical features and outcome of adult patients in southern Taiwan. Chang Gung Med J 2009; 32 (05) 509-516
- 6 Nayagam JS, Mullender C, Cosgrove C, Poullis A. Abdominal tuberculosis: diagnosis and demographics, a 10-year retrospective review from a single centre. World J Clin Cases 2016; 4 (08) 207-212
- 7 Sharma JB, Jain SK, Pushparaj M. et al. Abdomino-peritoneal tuberculosis masquerading as ovarian cancer: a retrospective study of 26 cases. Arch Gynecol Obstet 2010; 282 (06) 643-648
- 8 Uygur-Bayramicli O, Dabak G, Dabak R. Uygur-Bayrami & Ccedil O. A clinical dilemma: abdominal tuberculosis. World J Gastroenterol 2003; 9 (05) 1098-1101
- 9 Jadvar H, Mindelzun RE, Olcott EW, Levitt DB. Still the great mimicker: abdominal tuberculosis. AJR Am J Roentgenol 1997; 168 (06) 1455-1460
- 10 Maheshwari A, Kumar N, Gupta S. et al. Outcomes of advanced epithelial ovarian cancer treated with neoadjuvant chemotherapy. Indian J Cancer 2018; 55 (01) 50-54
- 11 Akhan O, Pringot J. Imaging of abdominal tuberculosis. Eur Radiol 2002; 12 (02) 312-323
- 12 Kapoor VK. Abdominal tuberculosis. Postgrad Med J 1998; 74 (874) 459-467
- 13 Rodríguez E, Pombo F. Peritoneal tuberculosis versus peritoneal carcinomatosis: distinction based on CT findings. J Comput Assist Tomogr 1996; 20 (02) 269-272
- 14 Chaudery M, Mohamed F, Shirol S, Gudgeon M. An unusual presentation of intra-abdominal tuberculosis in a young man. J R Soc Med 2010; 103 (05) 199-201
- 15 Riquelme A, Calvo M, Salech F. et al. Value of adenosine deaminase (ADA) in ascitic fluid for the diagnosis of tuberculous peritonitis: a meta-analysis. J Clin Gastroenterol 2006; 40 (08) 705-710