Mature Teratoma with Gliomatosis Peritonei with Abdominal Tuberculosis: A Diagnostic Dilemma

Abdominal tuberculosis constitute up to 12% of extrapulmonary TB and is sixth frequent site of extrapulmonary involvement. The most common sites of involvement is the ileocaecalregion. Other site of involvement in descending order are ascending colon jejunum, appendix, duodenum, stomach, esophagus, sigmoid colon and rectum. Abdominal TB has diagnostic dilemma due to its diverse and non-specific clinical presentation and has no single most specific, sensitive diagnostic test. A high index of suspicion, common and rare clinical feature, adequate imaging study, endoscopy, enteroscopy, laparoscopy, laparotomy, biopsy with histopathology, Mycobacterial isolation, Quantiferon-TB Gold, GeneXpert Assay, MULTIPLEX PCR and clinical response to anti TB therapy are considered for early diagnosis to reduce morbidity and mortality. Six month antiTB regime is effective as nine or 12month therapy. MDR TB and frequent interruption of therapy should considered in nonresponder to standard therapy. Surgery is required for minority cases that developed complications not responding to medical therpy.Medicine Today 2016 Vol.28(1): 39-45

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The role of laparoscopy in diagnosis of patients with chronic abdominal pain

International Surgery Journal ◽

10.18203/2349-2902.isj20164464 ◽

2016 ◽

Vol 4 (1) ◽

pp. 326 ◽

Cited By ~ 3

Author(s):

Pradeep Saxena

Keyword(s):

Abdominal Pain ◽

Clinical Picture ◽

Descriptive Analysis ◽

Abdominal Tuberculosis ◽

Chronic Abdominal Pain ◽

Diagnostic Dilemma ◽

Chronic Appendicitis ◽

Fluid Analysis ◽

Conclusive Diagnosis

Background: Chronic abdominal pain still remains one of the leading clinical problems presenting to physicians. Reaching a definitive diagnosis and prompt management is usually delayed because invasive investigations are frequently required to come to a conclusive diagnosis. The aim was to study the varied clinical picture of chronic abdominal pain and evaluate the role of laparoscopy in reaching a conclusive diagnosis in these patients.Methods: A prospective and retrospective study of 142 patients of chronic abdominal pain who underwent diagnostic laparoscopy in our surgery department from June, 2006 to December, 2015 was done. A descriptive analysis of data collected from case records of these patients was done to study the varied clinical picture, laboratory reports, radiological findings, laparoscopic findings and histological reports. The usefulness of laparoscopy to confirm the diagnosis and in clinical management of these patients of chronic abdominal pain was evaluated.Results:Laparoscopy was performed in 142 patients of chronic abdominal pain with unsettled diagnosis. A conclusive diagnosis could be made in 136 of these patients. The common causes of chronic abdominal pain were abdominal tuberculosis, adhesions, bands, small intestinal strictures, chronic appendicitis, abdominal malignancy and various gynecological diseases. Gynecological problems causing chronic abdominal pain were pelvic inflammatory disease, ovarian cyst, tubo-ovarian mass, hydrosalpinx, fibroid uterus, bulky uterus, endometriosis. Thus laparoscopy provided positive diagnosis of in 136 (95.77%) patients based on laparoscopic findings, histological reports, ascitic fluid analysis and cytology.Conclusions:In patients suspected to have abdominal pathology early laparoscopy may be useful to establish a conclusive diagnosis with acceptably low morbidity (<5 %). An early resort to laparoscopy can resolve the diagnostic dilemma and early treatment can be instituted.

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Importance of Laparoscopy to Solve the Diagnostic Dilemma of Abdominal Tuberculosis

KYAMC Journal ◽

10.3329/kyamcj.v12i1.53361 ◽

2021 ◽

Vol 12 (1) ◽

pp. 14-17

Author(s):

Md Saiful Islam ◽

Md Masudar Rahman ◽

M Fardil Hossain Faisal ◽

Md Alamgir Jalil Pramanik ◽

Muhammad Abdur Rouf

Keyword(s):

Minimally Invasive ◽

Diagnostic Laparoscopy ◽

Abdominal Cavity ◽

Correct Diagnosis ◽

Abdominal Tuberculosis ◽

Diagnostic Dilemma ◽

Peritoneal Tissue ◽

Appropriate Treatment ◽

Liver Surface ◽

Minimally Invasive Access

Background: Diagnosis of abdominal tuberculosis as well as histopathological confirmation is difficult because of suboptimal access to the intraperitoneal pathology. Laparoscopy provides minimally invasive access to the peritoneal cavity and materials can be collected for confirmation of diagnosis. Objectives: To study the importance of laparoscopy as a tool for the diagnosis of abdominal tuberculosis and initiation of appropriate treatment without delay. Materials & Methods: In this study 25 patients with suspected abdominal tuberculosis were selected within the period of May, 2014 to October, 2014. Diagnostic laparoscopy performed on all patients with biopsy of tissue from accessible sites. Results: Diagnostic laparoscopy with biopsy confirmed the diagnosis in 24 (96%) patients, 23 of these patients (96%) had nodules at different site of abdominal cavity and 19 of these patients (76%) had ascites. In two cases there were nodules over liver surface; biopsy was taken also from both liver nodules. One nodule revealed fibrosis and another nodule revealed tuberculosis. Conclusion: Imaging and culture of ascitic fluid may fail to confirm or exclude abdominal tuberculosis in clinically suspected cases. Laparoscopy with peritoneal tissue biopsy provided rapid and correct diagnosis of abdominal tuberculosis and should be performed early in suspected cases. KYAMC Journal.2021;12(01): 14-17

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Abdominal tuberculosis, a diagnostic dilemma: report of a series of cases

Medwave ◽

10.5867/medwave.2015.08.6271 ◽

2015 ◽

Vol 15 (08) ◽

pp. e6271-e6271 ◽

Cited By ~ 1

Author(s):

Richard Castillo Ramos ◽

Constanza Villalón Montenegro ◽

María Elena Molina Pezoa ◽

Gonzalo Urrejola Schmied

Keyword(s):

Abdominal Tuberculosis ◽

Diagnostic Dilemma

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Imaging appearance of ovarian mature teratoma with gliomatosis peritonei

Journal of Clinical Ultrasound ◽

10.1002/jcu.23100 ◽

2021 ◽

Author(s):

Min Zhang ◽

Tang Na Wu ◽

Hai Lin ◽

Ling‐ling Qin

Keyword(s):

Mature Teratoma ◽

Gliomatosis Peritonei ◽

Imaging Appearance

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Intracranial growing teratoma syndrome mimicking tumor relapse: a diagnostic dilemma

Journal of Neurosurgery Pediatrics ◽

10.3171/2009.1.peds0857 ◽

2009 ◽

Vol 3 (5) ◽

pp. 392-396 ◽

Cited By ~ 11

Author(s):

Doo-Sik Kong ◽

Do-Hyun Nam ◽

Jung-Il Lee ◽

Kwan Park ◽

Jong Hyun Kim ◽

...

Keyword(s):

Tumor Recurrence ◽

Mature Teratoma ◽

Germ Cell Tumors ◽

Clinical Manifestations ◽

Serum Marker ◽

Study Cohort ◽

Diagnostic Dilemma ◽

Primary Tumors ◽

Growing Teratoma Syndrome ◽

Second Look

Object It is important to differentiate growing teratoma syndrome (GTS) from tumor recurrence in the setting of an enlarging residual mass present after treatment of intracranial germ cell tumors (GCTs). The aim of this study was to determine the incidence of intracranial GTS and present its clinical manifestations in detail. Methods The authors performed a retrospective cohort study of 52 consecutive patients with newly diagnosed intracranial GCTs who presented between January 2000 and December 2006. The records were screened to identify a study cohort in which all patients had regrowing tumor mass despite normalization of tumor markers during or after treatment of GCTs. Results In 6 (11.5%) of 52 patients the pathological diagnosis was GTS. The median patient age at diagnosis was 14.5 years (range 2 months–17 years), and the primary tumors included 4 mixed GCTs and 2 immature teratomas. After second-look surgery, histological testing revealed the lesions to be mature teratoma in all patients. Three of 6 patients subsequently underwent radiation therapy and 1 patient received additional chemotherapy for spinal seeding. Conclusions In enlarging residual masses after treatment of intracranial GCTs, GTS should be kept in mind in the differential diagnosis of tumor recurrence especially if there is a radiographic mismatch with serum marker test results. If technically feasible, second-look surgery may be necessary for an accurate diagnosis.

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