Tuberculosis
is a global public health problem with 10 million people developing an active
form each year. The exact incidence of the pelvic form of tuberculosis is not
known due to under-reporting of asymptomatic cases, vague symptomatology and
lack of reliable diagnosis. We report a case of ovarian tuberculosis mimicking
cancer and peritoneal carcinosis. The case involved a 15-year-old girl,
hospitalized for severe pelvic pain and secondary amenorrhea. The examination
showed an altered general state, a fever, a sensitive distended abdomen. The
biology showed an elevation of Ca125 to 357 IU/ml. The CT scan showed a
latero-uterine mass taking contrast in a heterogeneous way with an irregular and nodular thickening of the peritoneum making evoke a peritoneal carcinosis. Exploratory
laparotomy found a bilateral ovarian mass with ileo-ileal, ileo-parietal
and ileo-ovarian adhesions. Biopsy of the mass and the peritoneum showed a
caseo-follicular gigantocellular epitheloid granulomatosis.
References
[1]
Sharma, J.B., Sharma, E., Sharma, S. and Dharmendra, S. (2018) Female Genital Tuberculosis: Revisited. Indian Journal of Medical Research, 148, S71-S83.
[2]
Adila, F., Brahimi, T. and Zitouni, A. (2017) Pulmonary and Pelviperitoneal Pseudotumor Tuberculosis Mimicking Metastatic Ovarian Tumor. Revue des Maladies Respiratoires, 34, A236-A237. https://doi.org/10.1016/j.rmr.2016.10.570
[3]
Neonakis, I.K., Spandidos, D.A. and Petinaki, E. (2011) Female Genital Tuberculosis: A Review. Scandinavian Journal of Infectious Diseases, 43, 564-572.
https://doi.org/10.3109/00365548.2011.568523
[4]
Akka, L., Khalil, H., Gannouni, N.C.I., Jalal, H., Samlani, Z., Fadil, K., et al. (2009) Ovarian Pseudotumor Tuberculosis: About Four Cases. Imagerie de la Femme, 19, 251-254. https://doi.org/10.1016/j.femme.2009.09.002
[5]
Global Tuberculosis Fund (2018) Good Practices for Tuberculosis Screening and Treatment. 76 p.
[6]
Shinga, B.W., Dièye, A., Badiane, N.M.D., Lakhe, N.A., Diallo, V.M.-P.C., Mbaye, K.D., et al. (2019) Intestinal Tuberculosis Revealed by Acute Bowel Obstruction during Paradoxical Reaction to Antituberculosis Treatment in an Immunocompetent Patient: About a Case and Literature Review. The Pan African Medical Journal, 32, 173. https://doi.org/10.11604/pamj.2019.32.173.17893
[7]
World Health Organization (2010) Treatment of Tuberculosis: Guidelines. World Health Organization.
[8]
Sharma, J.B., Roy, K.K., Pushparaj, M., Kumar, S., Malhotra, N. and Mittal, S. (2008) Laparoscopic Findings in Female Genital Tuberculosis. Archives of Gynecology and Obstetrics, 278, 359-364. https://doi.org/10.1007/s00404-008-0586-7
[9]
Nebhani, M., Boumzgou, K., Brams, S., Laghzaoui, M., El Attar, H., Bouhya, S., et al. (2004) Pelvic Tuberculosis Simulating a Bilateral Ovarian Tumour. Journal de Gynécologie Obstétrique et Biologie de la Reproduction, 33, 145-147.
https://doi.org/10.1016/S0368-2315(04)96414-9
[10]
Wang, Y.-C., Lu, J.-J., Chen, C.-H., Peng, Y.-J. and Yu, M.-H. (2005) Peritoneal Tuberculosis Mimicking Ovarian Cancer Can Be Diagnosed by Polymerase Chain Reaction: A Case Report. Gynecologic Oncology, 97, 961-963.
https://doi.org/10.1016/j.ygyno.2005.01.052
[11]
Koc, S., Beydilli, G., Tulunay, G., Ocalan, R., Boran, N., Ozgul, N., et al. (2006) Peritoneal Tuberculosis Mimicking Advanced Ovarian Cancer: A Retrospective Review of 22 Cases. Gynecologic Oncology, 103, 565-569.
https://doi.org/10.1016/j.ygyno.2006.04.010
[12]
Panoskaltsis, T.A., Moore, D.A., Haidopoulos, D.A. and McIndoe, A.G. (2000) Tuberculous Peritonitis: Part of the Differential Diagnosis in Ovarian Cancer. American Journal of Obstetrics & Gynecology, 182, 740-742.
https://doi.org/10.1067/mob.2000.103767
[13]
Akka, L., Khalil, H., Cherif Idrissi El Ganouni, N., Basraoui, D., Samlani, Z., Krati, K., et al. (2008) DIG-WS-25 Pseudotumoral Abdominopelvic Tuberculosis: A Propos de 7 Cases. Journal of Radiology, 89, 1554-1555.
https://doi.org/10.1016/S0221-0363(08)76804-5
[14]
Sharma, J.B., Jain, S.K., Pushparaj, M., Roy, K.K., Malhotra, N., Zutshi, V., et al. (2010) Abdomino-Peritoneal Tuberculosis Masquerading as Ovarian Cancer: A Retrospective Study of 26 Cases. Archives of Gynecology and Obstetrics, 282, 643-648.
https://doi.org/10.1007/s00404-009-1295-6
