Peritional Tuberculosis in Young Age Lady Miicking Gynecology Malignancy: a Case Report
DOI:
https://doi.org/10.25077/aoj.8.1.654-660.2024Abstract
Background : Peritoneal tuberculosis is one of the most challenging forms of extrapulmonary tuberculosis to diagnose. Extrapulmonary TB is very difficult to diagnose because of its non-specific signs and symptoms, thus it sometimes leads to a diagnosis of gynaecological malignancy such as advanced ovarian carcinoma.
Case Report : A teenage girl, 12 years old, with a chief complaint of intermittent abdominal pain since the last 1 month. There was no history of an enlarged abdomen, fever and weight loss. Ultrasound examination revealed an irregular adnexal mass suggesting an ovarian malignancy with other possibilities of an infectious process. Diagnostic laparoscopy and peritoneal biopsy were performed on the patient. Intraoperatively, multiple friable nodular-mylar peritoneal masses with abdominopelvic attachments and fibrin fibres and white vesicles were found on the entire surface of the genitalia, peritoneum, and intestines. A mass biopsy was performed with histopathological results showing peritoneal tuberculosis. Currently, the patient is undergoing anti-tuberculosis drugs (OAT) treatment.
Discussion : The diagnosis of this disease is difficult to establish. Symptoms are highly variable and non-specific and can lead to the wrong tumour pathology. The clinical characteristics are dominated by changes in general condition, abdominal pain and transit disorders, as well as masses (20 to 25%). The gold standard for definitive PTB diagnosis remains laparoscopy with peritoneal biopsy and subsequent pathological or microbiological confirmation. Yellow/white nodules in the peritoneum observed on the patient's laparoscopic images are the hallmark of wet peritoneal TB. Omental thickening and abdominal cocoon with matted small bowel are other classic laparoscopic findings for peritoneal TB.
Conclusion: PTB has similar characteristics to peritoneal carcinoma, which makes diagnosis difficult for clinicians. Early and correct diagnosis of PT
References
Koff A, Azar MM. Diagnosing peritoneal tuberculosis. BMJ Case Rep. 2020 Feb;13(2).
Wu DC, Averbukh LD, Wu GY. Diagnostic and Therapeutic Strategies for Peritoneal
Tuberculosis: A Review. J Clin Transl Hepatol. 2019 Jun;7(2):140–8.
Purbadi S, Indarti J, Winarto H, Putra AD, Nuryanto KH, Utami TW, et al. Peritoneal
tuberculosis mimicking advanced ovarian cancer case report: Laparoscopy as
diagnostic modality. Int J Surg Case Rep [Internet]. 2021;88:106495. Available from:
https://www.sciencedirect.com/science/article/pii/S2210261221009974
Bimantoro AS, Maimunah U. Diagnosis challenges of a patient with peritoneal
tuberculosis masquerading as ovarian malignancy: a case report. Bali Med J [Internet].
Dec 1;11(3 SE-CASE REPORT):1849–54. Available from:
https://www.balimedicaljournal.org/index.php/bmj/article/view/3892
Alrashed RF, Alkhuwaylidi AA, Aldashash KA, Albati NA, Algarni AA, Almodhaiberi H,
et al. Peritoneal Tuberculosis in a Young Healthy Male Resembling Intra-Abdominal
Malignancy. Vol. 13, Cureus. United States; 2021. p. e20677.
Terras Alexandre A, Raimundo S, Pinto C. Peritoneal tuberculosis – A rare diagnosis.
Pulmonology [Internet]. 2017;23(3):172–3. Available from:
https://www.journalpulmonology.org/en-peritoneal-tuberculosis-a-rare-articulo-
S2173511517300350
Zaslavsky J, Mulugeta-Gordon L, Vasko I, Presenza T, Scattergood E, Meislich D, et
al. Tuberculous peritonitis in children: Two case reports highlighting the important role
of imaging. Radiol Case Reports [Internet]. 2018;13(4):862–6. Available from:
https://www.sciencedirect.com/science/article/pii/S193004331830147X
ELmajdoubi H, EL Yahiyaoui M, Baiss M, Bouzroud M, Aboulfeth EM, Najih M, et al.
Abdominopelvic Mass Revealing Tuberculosis in a Young Woman. Mantas D, editor.
Case Rep Surg [Internet]. 2021;2021:7257533. Available from:
https://doi.org/10.1155/2021/7257533
Sen D, Brunton J, Melchior L, Klein D, Levy GH, Wainscoat B, et al. Peritoneal
tuberculosis: A case report on a rare cause of tumor marker elevation. Vol. 28, Case
reports in women’s health. Netherlands; 2020. p. e00264.
Maheshwari A, Gupta S, Rai S, Rekhi B, Kelkar R, Shylasree TS, et al. Clinical and
Laboratory Characteristics of Patients with Peritoneal Tuberculosis Mimicking
Advanced Ovarian Cancer. South Asian J cancer. 2021 Apr;10(2):102–6.
Rinaldi I, Muthalib A, Gosal D, Wijayadi T, Sutedja B, Setiawan T, et al. Abdominal
Tuberculosis Mimicking Ovarian Cancer: A Case Report and Review of the Literature.
Vol. 15, International medical case reports journal. New Zealand; 2022. p. 169–85.
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Lusi Jelita Sari, Puja Agung Antonius, Syamel Muhammad
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright
Authors who publish with this journal agree to the following terms:
- Authors retain the copyright of published articles and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution 4.0 International License that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
License:
Andalas Obstetrics and Gynecology Journal (AOJ) is published under the terms of the Creative Commons Attribution 4.0 International License. This license permits anyone to copy and redistribute this material in any form or format, compose, modify, and make derivatives of this material for any purpose, including commercial purposes, as long as they credit the author for the original work.
