Isolated ovarian tuberculosis mimicking ovarian carcinoma: Case report and literature review

Abstract

Although genitourinary tuberculosis is common, reports of isolated ovarian tuberculosis are rare. However, its presentation can mimick that of an ovarian tumour, leading to diagnostic difficulties. A woman of 17 years presented with chronic pelvic pain, weight loss, a right ovarian mass on ultrasound, and a significantly elevated CA-125 level. A diagnosis of ovarian carcinoma was made, and laparotomy was performed with resection of the right ovary. Postoperative histological examination, however, revealed classic tuberculoid appearances, with no signs of malignancy. Antituberculosis treatment was commenced, with full resolution of her symptoms and a decrease in CA-125 level. Isolated ovarian tuberculosis is most common in young women living in endemic zones. CA-125 can be raised in both conditions, and imaging is rarely conclusive. Intraoperative frozen section of tissue specimens can be helpful if available. Early diagnosis of ovarian tuberculosis is vital as untreated disease can lead to infertility.

Isolated ovarian tuberculosis in an Immuno- competent woman in the post partum period: case report

“…In ovarian Tb, the clinical presentation cam mimic ovarian malignancy which was also evident in our case in whom a diagnosis of ovarian tumor was made based on clinical and US findings. It should be noted that diagnostic imaging tests are non specific and both US and CT/MRI scan appearances are similar in both ovarian tuberculous abscess and other neoplastic ovarian masses [ 6 ]. An elevated CA-125 level is also found in some of the patients with ovarian Tb which further increases the diagnostic dilemma [ 5 , 6 , 9 ].…”

“…Laparoscopy and laparotomy are important in the diagnosis of ovarian/tubo-ovarian Tb. Intraoperative frozen sections (if available) are valuable to rule out the possibility of pelvic Tb in patients undergoing surgery for tubo-ovarian masses, especially in highly prevalent areas [ 6 ]. Hence keeping in mind the possibility of tubo-ovarian TB is crucial as it will avoid radical/extensive surgery and unnecessary removal of the ovaries for suspected ovarian malignancy in reproductive age women who desire to retain/preserve fertility.…”

“…The classical presentation of Female genital tuberculosis is with a triad of infertility, menstrual irregularity & chronic pelvic pain. But isolated ovarian tuberculosis presenting as an adnexal mass and mimicking ovarian tumor is an extremely rare clinical variety and is reported only twice in the literature [ 6 ]. In here, a very rare case of an isolated unilateral ovarian tuberculosis in a woman in the postpartum period is presented.…”

In Front of Bilateral Pseudo Tumoral Ovarian Mass: Think about Tuberculosis

“…However, this rise remains non-specific as it can be observed in various circumstances such as pregnancy, ovarian cysts, uterine cancer, colon, lung and pancreatic cancer ... [9]. The association of tuberculosis and high levels of CA125 has been reported in the literature, and its decrease might be a good marker for an appropriate response after anti-tuberculosis treatment [2] [10].…”

Tuberculosis: Common disease with uncommon presentation: A case series

“…The disease may remain asymptomatic or may lead to pelvic pain, fever, menstrual disturbances or vaginal discharge. Very few cases of isolated ovarian tuberculosis mimicking ovarian malignancy with raised CA125 level without any primary lung involvement have been reported 17 . Our case is unique as it presented with menorrhagia which has not been reported so far.…”