Pelvic Tuberculosis Simulating an Ovarian Tumor at a Stage of Peritoneal Carcinosis
2021
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.
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