CT findings and analysis for misdiagnosis of female pelvic tuberculosis

Pelvic tuberculosis: a forgotten diagnosis – case report

“…This is one further argument stressing the importance of this case promoting awareness in considering tuberculosis as part of the diagnostic workup of adnexal masses, especially in patients with a long potential fertile/reproductive life ahead. As presentation is often so insidious and nonspecific (majority presenting with abdominal pain, infertility, or abnormal menstrual cycles/bleeding), the diagnosis is highly supported in imaging findings, but they can be misleading as granulomata spreading throughout the peritoneal surfaces and omenta may appear as enhancing nodular thickening, suggesting carcinomatosis [3] . Furthermore, the complex adhesions elicited by the inflammatory response distort the anatomical planes and surrounding structures, hampering the Radiologist's task.…”

“…IGRA was particularly helpful overcoming the interference of BCG vaccination and further supporting the diagnosis. A great confounding factor is still CA-125, whose increased levels are readily attributed to a malignant ovarian process, and this report also serves to emphasize the fact that elevated levels of CA-125 can be produced by inflammation of epithelial cells (peritoneum, pleura and pericardium) explaining why it can be increased in varied situations such as infections, tuberculosis, endometriosis, Meigs syndrome, menstruation, pericarditis, pneumonia, and acute pancreatitis [3] , [6] . Normalization of CA-125 levels has been associated with the response to anti-TB therapy [4] , which we also verified in our case.…”

“…Due to its insidious nature and nonspecific signs and symptoms, radiological investigation plays a crucial role in the early and correct identification of the disease. However, owing to its rarity and the fact that it is restricted to some epidemiologic contexts, imaging findings are easily misdiagnosed as advanced ovarian malignancy or pelvic inflammatory disease [3] . With this case report [4] , we aim at promoting recognition and understanding of the imaging findings spectra associated with female pelvic TB and emphasize the need for integration with clinical and laboratory data that are crucial to avoid misdiagnosis, delay of treatment (allowing disease progression), and surgical exploration.…”

Etiopathogenesis, Challenges and Remedies Associated With Female Genital Tuberculosis: Potential Role of Nuclear Receptors

“…The misdiagnosis rate is very high among FGTB patients and is associated with several complications. The disease is mistaken for other gynecological conditions or malignancy; for example, FGTB is misdiagnosed as ovarian cancer or chocolate cyst or pelvic inflammatory disease (PID) ( 54 ), and FGTB patients who are reported to have cervical TB may masquerade as cervical cancer ( 41 , 55 ). Additionally, FGTB patients may be mistaken or coexist with acute appendicitis or ectopic pregnancy ( 52 ).…”

Imaging as an alternate diagnostic modality in a presumptive case of abdominopelvic TB in a COVID-19 patient

“…3 Although several cases of FGTB are associated with abdominal TB, specific features of FGTB on a CT scan include pelvic mass, unilateral or bilateral adnexal mass(which maybe solid/mixed echogenicity/cystic), tuboovarian abscess, ascites, thickening of peritoneum (which maybe nodulous thickening or smooth), adhesions and lymphadenopathy (which maybe necrotic). 4 Laparoscopy plays an important role for the diagnosis of FGTB. Features suggestive of FGTB on laparoscopy include-tubercles on peritoneum, tubo-ovarian mass, caseous nodules, encysted ascitis, pelvic adhesions, hydrosalpinx, tobacco pouch appearance of tube and beaded tubes.…”