• Lusi Jelita Sari Obstetrics and Gynecology Department, Faculty of Medicine, Universitas Andalas, Padang
  • Puja Agung Antonius Oncology Ginecology Division of Obstetrics and Gynecology Department, Faculty of Medicine Universitas Andalas, Padang
  • Syamel Muhammad Oncology Ginecology Division of Obstetrics and Gynecology Department, Faculty of Medicine Universitas Andalas, Padang



peritoneal tuberculosis, gynecological malignancy, young age


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 PTB helps to initiate medical management

quickly and helps reduce morbidity and mortality.


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