Abdomino Pelvic Tuberculosis Versus Advanced Ovarian Malignancy : A Diagnostic Dilemma

Abstract

Pelvic tuberculosis a common infectious cause of human death remains a global health problem, primarily in developing countries .Diagnosis of extra-pulmonary tuberculosis is challenging as it is rarely pinpointed by clinical symptoms, laboratory and radiological findings of low specificity. Pelvic tuberculosis should be considered in young women presented with pelvic mass, ascites and elevated serum CA 125. A series of fourteen cases between the 20 to 70 years are being reported having spectrum of clinical feature and creating diagnostic dilemma. The final diagnosis was made by histopathology after FNAC, laparoscopy or laparotomy are reviewed here. So the aim was formulation of high degree of suspicion aided by intensive investigation for timely diagnosis of genital tuberculosis, to see the response of antituberculer therapy and avoid unnecessary extended surgery.

Abdominal Tuberculosis Mimicking Ovarian Cancer on Ct Scan: The Value of Chest X-Ray in Diagnosis

“…Currently, there is no available classification to determine the degree of abdominal tuberculosis extension that resembles ovarian mass. Therefore, we tried to arrange a scoring system based on previous studies regarding abdominal TB characteristics [6,[10][11][12][13]. The lowest score was 4, which was included in mild degree category, and the highest score was 13, which was included in severe degree category.…”

“…The degree of abdominal TB extent from abdominal CT-scan findings with contrast was classified based on previous studies and had been published and used the following scoring system: • Mild, if the score is between 5-8 • Moderate, if the score is between 9-12 • Severe, if the score is more than 12 [6,[10][11][12][13]].…”

Endometrial Tuberculosis Simulating an Ovarian Cancer: a case report

“…4 After treatment, reduction of ascites and CA-125 serum levels have been described, as well as abdominal distension and abdominopelvic mass resolution. 2 In conclusion, the diagnosis of FGTB remains a challenge, due to the wide range of clinical presentations, non-specific laboratory findings and the superimposition of…”

“…1 Genitourinary TB accounts for about 15% of all extra-pulmonary TB and, after lung, is the most common site. 2 The endometrium is involved in approximately 50-60% of women with female genital TB (FGTB). [3][4][5][6][7][8] FGTB is typically asymptomatic and is usually diagnosed incidentally during infertility evaluation.…”

“…2 FGTB presenting as abdominal lump with raised cancer antigen 125 (CA-125) and ascites can be a differential diagnosis of advanced ovarian malignancy or disseminated peritoneal carcinomatosis. 2 No laboratory test is sufficiently sensitive or specific to allow a diagnosis; however lymphocytosis, accelerated erythrocyte sedimentation rate (ESR) and increased gamma-globulin levels in blood can be found. The imaging findings are also not specific.…”