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Primary Peritoneal Tuberculosis with Ascites and Elevated CA 125 Mimicking Advanced Ovarian Carcinoma

There are an increasing number of atypical forms of tuberculosis in the world, including pelvic tuberculosis. This is mainly seen in developing countries with poor health care and a high prevalence of HIV positive population. Pelvic tuberculosis is rare and difficult to diagnose because of nonspecific and often atypical clinical manifestations. Symptoms of the disease can mimic malignancies and are often mistaken for adnexal tumors, especially if ascites is present. Incorrect diagnosis and therapy choice are made, often with mutilating unnecessary surgical treatments. The diagnosis is made following biopsy and pathohistology analysis, excluding malignanancies retrospectively. Diagnostic laparoscopy with target biopsy and PCR is one of the fundamental diagnostic methods in making the right diagnosis. We present a rare case of pelvic tuberculosis presenting with urinary incontinence, ascites and a rise in tumor marker CA-125 misdiagnosed as a gynaecological malignancy at first. When treating gynaecological symptoms pelvic tuberculosis mimicking gynaecological malignancies must be considered.

pelvic tuberculosis, adnexal mass, diagnostic laparoscopy, ovarian cancer, CA-125

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