Case report of a pelvic-peritoneal tuberculosis presenting as an adnexial mass and mimicking ovarian cancer, and a review of the literature.

摘要: A 49-year-old perimenopausal woman, gravida 7, para 5 was referrred to our gynecology clinic for the evaluation of extensive ascites. From her history we learned that she had been admitted rheumatology with complaints arthalgia and fatigue 2 months previously given salazopyrin therapy past a presumptive diagnosis rheumatoid or infective arthritis. After 15 days started feel abdominal swelling distension, difficulty in breathing an epigastric burning sensation. She not experienced any gynecological other than irregular menses 6 weight loss few months. The patient described something like hot-flush during nights, but there were no measured body temperatures available so it impossible make discrimination between fever hot-flush. Abdomino-pelvic CT (computerized tomography) demonstrated mild splenomegaly, lobulation uterine contours hypodens lesions on right side myometrium ascites abdomen. Transvaginal ultrasound irrelevant except 25 x 31 mm pure cystic adnexial mass. Doppler confirmed 26 22 mass, solid components pathological blood flows impedence measures. Laboratory findings all within normal ranges elevated eritrocyte sedimentation rate CA 125 (normal range is 0–35) which 84 844.8 respectively. Liver function tests viral immunologic markers negative. On basis these planned exploratory laparotomy presumption ovarian cancer. For this age, chest x-ray routine procedure clinic, therefore did take before operation. day operation, about month later first one, performed another transvaginal found mass lesion increased size 57 51 mm. At laparotomy, miliary deposits seen hemidiaphragmatic surfaces, surface liver, peritoneal surfaces covering walls serozal small bowels, at sight misdiagnosed as metastatic 50 originating from ovary 30 40 plaque mesentery ileum (which thought