scholarly journals A Case of Disseminated Peritoneal Tuberculosis Mimicking Metastatic Ovarian Carcinoma

Author(s):  
Ishita Mishra ◽  
Nimish C Pandya ◽  
Nilopher Surti ◽  
Babu S Patel

ABSTRACT Background Mycobacterium tuberculosis affects about 30% of world's population and infection occurs at a rate of one per second. In 2010, tuberculosis accounted for 8.8 million new cases, was responsible for 1.45 million deaths with majority of cases in developing countries. Tuberculosis is the most common cause of mortality in women of reproductive age. Peritoneal tuberculosis accounts for 4% of all extrapulmonary diseases and often mimics ovarian malignancy due to its nonspecific symptoms. Case A 25-year-old woman with ovarian mass and an elevated cancer antigen 125 (CA-125) underwent an exploratory laparotomy to search for ovarian tumor. The final pathological diagnosis was miliary abdominal tuberculosis. Discussion Peritoneal tuberculosis often mimics ovarian malignancy due to its nonspecific symptoms and is a major health problem in developing countries. There is no particular diagnostic test to differentiate this disease from advanced ovarian carcinoma, making it difficult to avoid extensive surgery. Laparoscopy is the diagnostic modality of choice. How to cite this article Surti N, Patel BS, Pandya NC, Mishra I. A Case of Disseminated Peritoneal Tuberculosis Mimicking Metastatic Ovarian Carcinoma. J South Asian Feder Menopause Soc 2014;2(1):44-45.

2010 ◽  
Vol 20 (5) ◽  
pp. 798-803 ◽  
Author(s):  
Chel Hun Choi ◽  
Chul-Jung Kim ◽  
Yoo-Young Lee ◽  
Joo Sun Kim ◽  
Taejong Song ◽  
...  

Introduction:To evaluate the clinical features of peritoneal tuberculosis (TB) and to compare them with those of primary peritoneal carcinoma (PPC).Methods:We conducted a retrospective review of women with peritoneal TB who were managed at Samsung Medical Center from January 1996 to October 2006. As a control sample, patients with a diagnosis of PPC during the same period were also selected for comparison.Results:During the study period, we identified 20 female patients with peritoneal TB. The median age was 39 years (range, 23-69 years), and the median cancer antigen 125 (CA-125) level was 448 U/mL (range, 32-1725 U/mL). Seventeen patients with PPC whom we examined were older, with a median age of 63 years (range, 50-73 years); their median CA-125 level was higher at 1848 U/mL (range, 42-14,380 U/mL). Compared with those of PPC, the radiologic findings of peritoneal TB indicated less severe involvement of the omentum and the mesentery (P = 0.03). Among the 20 patients who underwent operations, 6 (30%) underwent exploratory laparotomy; 12 (60%), diagnostic laparoscopy; and 2 (10%), laparoscopy converted to laparotomy because of severe adhesion. Frozen tissue sections revealed chronic granulomatous tissue reaction in 15 (83.3%) of 18 women with peritoneal TB.Conclusions:Maintaining a high index of suspicion is very important for the successful treatment of peritoneal TB, especially in developing countries. Age, CA-125 level, and omental involvement as identified by computed tomography may be helpful for the differential diagnosis of peritoneal TB and PPC.


2021 ◽  
Vol 14 (3) ◽  
pp. e238931
Author(s):  
Alicia Palmieri ◽  
Karim ElSahwi ◽  
Verda Hicks

A 64-year-old woman referred to Gynaecological Oncology secondary to the finding of pelvic mass and ascites. Imaging showed multiple pelvic masses, with the largest mass measuring 20 cm in diameter, as well as bilateral pleural effusions and abdominal ascites, suspicious for ovarian carcinoma. Laboratory findings included elevated cancer antigen 125 (CA-125) of 2124 units/mL. The patient underwent an exploratory laparotomy, total abdominal hysterectomy and bilateral salpingo-oophorectomy for pathological evaluation. Postoperatively, the patient had resolution of ascites and pleural effusion. Surgical pathology revealed a 26 cm right ovarian fibroma, confirming the diagnosis of Meigs syndrome. Despite the high suspicion for ovarian carcinoma in patients presenting with elevated CA-125 level, pelvic mass, ascites and pleural effusion, the diagnosis of Meigs syndrome cannot be excluded without pathological evaluation of mass.


Author(s):  
Vijay Zutshi ◽  
Shreshtha Gupta ◽  
Charanjeet Ahluwalia ◽  
Monica R.

Endometriosis is an estrogen dependant disorder of reproductive-age women. It is uncommon after menopause, however, peripheral estrogen production may account for endometriosis in post-menopausal women. We reported a case of a 68 year old post-menopausal woman with an adnexal mass suspected malignant ovarian tumor on imaging and normal serum CA 125 levels. Total hysterectomy with bilateral salpingo-oophorectomy was done. The final histopathology revealed the diagnosis of ovarian endometriosis. Rarely, ovarian endometrioma can mimic ovarian malignancy in a post-menopausal woman.


Author(s):  
Żaneta Kimber-Trojnar ◽  
Aleksandra Pilszyk ◽  
Magdalena Niebrzydowska ◽  
Zuzanna Pilszyk ◽  
Monika Ruszała ◽  
...  

Endometriosis is a disease that affects women of reproductive age and has a significant impact on their well-being. The main symptoms are dysmenorrhea, chronic pelvic pain and infertility. The diagnostic process in many cases is very long and can take up to 8-12 years. Laparoscopy, which is an invasive method, is still necessary to confirm final identification. Therefore, the development of diagnostic markers seems to be crucial for the diagnosis and proper treatment of women affected by endometriosis as soon as possible. Still the most frequently studied and used marker is Cancer Antigen 125 (CA-125). Other glycoproteins, growth factors and immune markers seem to play an important role. However, the search for the ideal endometriosis marker is still ongoing. Developing researches on endometriosis pathogenesis help to identify potential biomarkers or sets of biomarkers in order to improve and speed up the diagnostic process in a non-invasive way.


2015 ◽  
Vol 12 (3) ◽  
pp. 219-221
Author(s):  
D Mallick ◽  
M Saha ◽  
S Chakrabarti ◽  
J Chakraborty

Tumors of the broad ligament are uncommon. Leiomyoma, which is the commonest female genital neoplasm, is also the most common solid tumor of the broad ligament. Leiomyomas affect 30% of all women of reproductive age but the incidence of broad-ligament leiomyoma is <1%. These benign tumors are usually asymptomatic. A case is being described where a 52 year old presented with gradual abdominal swelling which was clinically and radiologically diagnosed as ovarian malignancy. On abdominal and bimanual palpation a soft cystic mass was noted in the right pelvic region. CA 125 was mildly raised. CEA, CA 19.9 levels were within normal limit. The radiological diagnosis was ovarian cyst with possibility of malignant changes. Staging laparotomy and histopathological examination of the resected specimen revealed a right sided broad ligament leiomyoma with cystic changes. The degenerative changes in the leiomyoma lead to the clinical and radiological diagnostic confusion. Thus, though uncommon, broad ligament leiomyoma should be considered during evaluation of adnexal masses for optimal patient management. The above description of leiomyoma in the broad ligament is a highly unique case and thus deserves appropriate attention.Kathmandu University Medical Journal Vol.12(3) 2014; 219-221


1988 ◽  
Vol 34 (12) ◽  
pp. 2513-2516 ◽  
Author(s):  
K W Ryder ◽  
T O Oei ◽  
M T Hull ◽  
M M Sample

Abstract The performance of a new enzyme immunoassay (EIA) procedure (Abbott Labs.) for cancer antigen 125 (CA 125) met or exceeded the manufacturer's claims for all analytical variables examined. Overall correlation with results obtained with a radioimmunoassay (RIA) were good. However, near the decision thresholds typically chosen to define a positive result for ovarian carcinoma, EIA results were 10 to 20 arbitrary units/mL less than the RIA results. At specific decision thresholds, therefore, the sensitivities and specificities of the EIA and RIA procedure differed. Adjusting the decision thresholds gave a similar optimum efficiency for each procedure: EIA, 82.9% (decision threshold, 35 units/mL); RIA, 83.4% (decision threshold, 54 units/mL). Receiver-operating characteristic curves showed that the two procedures' ability to distinguish patients with active ovarian carcinoma from those with disease in remission was the same.


2021 ◽  
Vol 10 (13) ◽  
pp. 2762
Author(s):  
Żaneta Kimber-Trojnar ◽  
Aleksandra Pilszyk ◽  
Magdalena Niebrzydowska ◽  
Zuzanna Pilszyk ◽  
Monika Ruszała ◽  
...  

Endometriosis is a disease that affects women of reproductive age and has a significantly negative impact on their well-being. The main symptoms are dysmenorrhoea, chronic pelvic pain and infertility. In many patients the diagnostic process is very long and can take up to 8–12 years. Laparoscopy, an invasive method, is still necessary to confirm the diagnosis. Therefore, development of more effective diagnostic markers appears to be of the utmost importance for early diagnosis of endometriosis and provision of appropriate treatment. From a clinical point of view, detection of early-stage endometriosis in asymptomatic patients is an ideal situation since early diagnosis of endometriosis may delay the onset of symptoms as well as prevent progression and complications. In the meantime, Cancer Antigen 125 (CA-125) is still the most frequently studied and used marker. Other glycoproteins, growth factors and immune markers seem to play an important role. However, the search for an ideal endometriosis marker is still underway. Further studies into the pathogenesis of endometriosis will help to identify biomarkers or sets of biomarkers with the potential to improve and speed up the diagnostic process in a non-invasive way.


Author(s):  
Beng Hock Teh ◽  
Soon Leong Yong ◽  
Wee Wee Sim ◽  
Kim Bee Lau ◽  
Haris Njoo Suharjono

Abstract Background This study was conducted to evaluate the performance of human epididymal protein 4 (HE4), cancer antigen 125 (CA 125) and a combination of both via the Risk of Ovarian Malignancy Algorithm (ROMA) in detecting ovarian malignancy. Methods This was a diagnostic study enrolling 129 patients with pelvic mass(es) suspected of originating in the ovary who had been scheduled for surgery or radiological-guided biopsy. Serum HE4 and CA 125 levels were measured. HE4, CA 125 and ROMA were evaluated for sensitivity, specificity, positive predictive value and negative predictive value. The receiver operating characteristic (ROC) plots were graphed and area under the curve (AUC) values were calculated to investigate the accuracy of each marker for predicting ovarian malignancy. Results Overall, CA 125 remained significantly more sensitive (88.9% vs. 51.9%, p = 0.006) but less specific (56.9% vs. 95.1%, p < 0.001) than HE4. HE4 was superior to CA 125 in specificity (97.7% vs. 54.5%, p < 0.001) for premenopausal women. ROMA was non-significantly more sensitive (100.0% vs. 92.3%, p = 1.000) than CA 125 but both were equally specific (71.4%) for the postmenopausal group. In the premenopausal group, the AUC of serum HE4 was higher than serum CA 125 (0.851 vs. 0.817) but was equivalent to ROMA (0.851 vs. 0.859). In the postmenopausal group, ROMA exhibited an excellent AUC value as compared to CA 125 and HE4 (AUC of 0.907 vs. 0.874 vs. 0.863, respectively). Conclusion HE4 is useful in ruling out ovarian malignancy among premenopausal women. For postmenopausal women, ROMA appears to be an all-rounder with overall good sensitivity and specificity.


KYAMC Journal ◽  
2018 ◽  
Vol 9 (3) ◽  
pp. 139-140
Author(s):  
Raihana Musawwir ◽  
Sheuly Akhter ◽  
Fatema Begum

CA-125 (cancer antigen 125, carcinoma antigen 125, or carbohydrate antigen 125) also known as mucin 16 or MUC16 is a protein of mucin family glycoprotein that is encoded by the MUC16 gene. It is the most frequently used biomarker for ovarian cancer. It may also be elevated in other cancers, including endometrium, fallopian tube, lung, breast and gastrointestinal cancer and in a number of relatively benign conditions, such as endometriosis, menstruation and pregnancy. High plasma levels of more than 200 U/mL are usually suggestive of malignancy but rarely found in benign conditions of female genital tract, like endometriosis. Very high CA- 125 level is suggestive of ovarian malignancy, was noted in case of ovarian endometrioma. This paper describes a case of a 36 years old lady, mother of 2 children, was admitted with large abdominal mass and abdominal pain. CA-125 was found 3500 U/ML. Ovarian malignancy was suspected. During laparotomy, ruptured endometrioma was noted and it was supported by histopathological report which mentioned," No malignancy seen". Endometrioma can't be excluded in high CA-125 level even without features of endometriosis.KYAMC Journal Vol. 9, No.-3, October 2018, Page 139-140


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