Peritoneal tuberculosis mimicking peritoneal carcinomatosis

Abstract

Purpose: The data of 11 peritoneal tuberculosis (TB) patients is discussed in an attempt to better understand this disease. Methods: Nine patients with clinical features mimicking ovarian cancer and two with infertility were evaluated retrospectively. Results: The mean age was 40.8 ± 18.3 years. None had any past/family history of TB. Abdominal swelling and pain, appetite loss, nausea/vomiting, and primary infertility were the most common complaints. Chest X-ray suggested TB in one cachexie patient. Six patients had ovarian/primary peritoneal cancer on laparotomy. Laparoscopy was performed to determine therapeutic modality in one patient and for primary infertility in one patient. Three patients were not operated because of suspected TB in one and neoadjuvant chemotherapy in two with poor performance scores. They underwent peritoneal or omental biopsies; histopathology revealed caseous granulomatous TB lesions. Mycobacterium tuberculosis was identified in only two ascitic fluid cultures. Conclusion: Peritoneal TB should be suspected in endemic areas, especially in young patients considered to have peritoneal carcinomatosis.