A previously healthy 49-year-old woman from the Philippines who had lived in Japan for over 20 years presented with fatigue and abdominal distension for a month. Computed tomography revealed massive ascites (Picture 1, yellow arrows) and a small calcification in the right ovary (Picture 2A, yellow arrow). A ruptured ovarian or intestinal tumor with peritoneal metastasis was suspected, and an operation was performed. Pathological findings were nonmalignant; however, white masses consisting of an epithelioid granuloma were detected in both ovaries (Picture 2B, C; black arrowheads). Acid-fast smears of the ascites and sputum were negative, but Mycobacterium tuberculosis was cultured from the ascites. She was diagnosed with peritoneal and ovarian tuberculosis without pulmonary lesions and completely recovered after 12 months of anti-tuberculosis therapy. Consistent with previous reports, tuberculosis may mimic an intra-abdominal tumor with peritoneal metastasis (1,2), and physicians should include it as a differential diagnosis in such patients.
Picture 1.
Picture 2.
The authors state that they have no Conflict of Interest (COI).
References
- 1. Abi El Hessen T, Saleem S, Hani RH, Chadli FZ, Makarem JA. Peritoneal tuberculosis mimicking peritoneal carcinomatosis in an immunocompetent patient. Cureus 14: e31464, 2022. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2. Kattan J, Haddad FG, Menassa-Moussa L, et al. Peritoneal tuberculosis: a forsaken yet misleading diagnosis. Case Rep Oncol Med 2019: 5357049, 2019. [DOI] [PMC free article] [PubMed] [Google Scholar]