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450 Abdominal tuberculosis mimicking carcinomatosis
  1. R Pedrini Cruz,
  2. M da Rosa Duarte,
  3. G Peretti Rodini,
  4. A Rosso Bianchi,
  5. M Pase Casasola and
  6. P Bibiana Müller Nunes
  1. Hospital Nossa Senhora da Conceição, Oncogynecology, Porto Alegre, Brazil


Objectives To report an abdominal tuberculosis simulating ovarian cancer.

Methods The information has been obtained through review of medical records and review of the literature.

Results A 17-year-old female patient was admitted in the hospital due to fever, abdominal pain, ascites, and previous laparoscopy that evidenced carcinomatosis and ovary lesions. Serum CA-125 was 1529.8 U/ml and lactate dehydrogenase (LDH) was 2353 U/ml. Abdominal magnetic resonance (MR) evidenced lesions with expansive aspect in adnexal regions, presenting an intermediate signal in the T1 and T2 weights, areas of contrast enhancement and water diffusion restriction, suggesting a neoplastic process. Thorax CT was suggestive of active granulomatous infectious process. An uncle died a year ago by tuberculosis and other was being treated for tuberculosis pulmonary infection. HIV serology was negative. Previous laparoscopy material was reexamined by our pathologists, showing active chronic salpingitis with necrotic granulomas, and absence of acid-fast bacilli. A laparoscopy with peritoneal biopsies was performed. Pathology analysis evidenced acid-fast bacilli, compatible with mycobacteriosis. Late cultural examination was compatible with Mycobacterium tuberculosis. She was treated with rifampin, isoniazid, pyrazinamide and ethambutol for two months, followed by four months maintenance treatment with rifampin and isoniazid. Five months after treatment end, the patient was asymptomatic.

Conclusions Tuberculosis should be considered as a differential diagnosis of ovarian cancer, especially in endemic areas.

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