Panacea Journal of Medical Sciences

---

Deciphering the diagnostic dilemma of abdominopelvic tuberculosis and advanced ovarian cancer

Full Text PDF Share on Facebook Share on Twitter

---

Original Article

Author Details : Anitha Gandhi*, Sundaram Shanmugasundaram, Deepa Shunmugam

Volume : 11, Issue : 2, Year : 2021

Article Page : 305-308

https://10.18231/j.pjms.2021.062

Suggest article by email

---

Abstract

Background: Abdominopelvic tuberculosis often poses a diagnostic challenge due to its bizarre clinical features and inconclusive imaging features. Most such patients were categorized under advanced ovarian cancer and undergo radical cytoreductive surgery with its associated morbidity, which would otherwise resolve spontaneously with medical management.
Materials and Methods: This is a retrospective study of ten patients referred to the Department of Surgical Oncology between November 2015 to October 2018 in a tertiary care centre at south Tamil Nadu, India as advanced ovarian cancer and later diagnosed to have tuberculosis.
Results: In 10 patients, the mean age was 34 years; mean CA125 was 496.6 IU/ml. abdominal pain and distension, loss of weight were seen in 70% of cases, respectively.Only one patient had a prior history of tuberculosis. The imaging findings were complex adnexal mass in 9 patients (90%), ascites in 6 patients (60%) and omental stranding in 6 patients (60%). Abdominal paracentesis was done in 6 patients (60%) and all had lymphocyte rich effusion. The diagnosis is established by laparotomy and biopsy in seven patients (70%), diagnostic laparoscopy in two patients (20%) and image-guided trucut biopsy in one patient (10%) with histopathology revealing caseating granulomas.
Conclusion: With our patients' experience, a high index of suspicion is always needed whenever we encounter young women presenting with ascites, adnexal mass and elevated serum CA125 even when the routine investigations for tuberculosis reveal negative findings. The biopsy is the gold standard for establishing the diagnosis and to commence therapy.
 

Keywords: peritoneal tuberculosis, ascites, CA 125, abdominopelvic tuberculosis

How to cite : Gandhi A, Shanmugasundaram S, Shunmugam D, Deciphering the diagnostic dilemma of abdominopelvic tuberculosis and advanced ovarian cancer. Panacea J Med Sci 2021;11(2):305-308

Copyright © 2021 by author(s) and Panacea J Med Sci. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License (creativecommons.org)