A Rare Presentation of Peritoneal Tuberculosis Mimicking Malignancy

Area of Science:

• Infectious Diseases
• Rheumatology
• Oncology

Background:

• Peritoneal tuberculosis is an uncommon form of extrapulmonary tuberculosis.
• It often presents with non-specific symptoms, mimicking intra-abdominal malignancies.
• Elevated serum cancer antigen 125 (CA-125) is typically associated with ovarian cancer but can be raised in other conditions.

Purpose of the Study:

• To report a rare case of peritoneal tuberculosis presenting with elevated serum CA-125 and rheumatoid factor (RF).
• To highlight the diagnostic challenge posed by peritoneal tuberculosis mimicking abdominal cancer.
• To increase physician awareness of tuberculosis as a cause for elevated RF in the absence of rheumatologic disease.

Main Methods:

• Literature review for similar reported cases.
• Clinical case presentation of a 63-year-old female with large abdominal ascites.
• Diagnostic workup including biopsy to rule out malignancy.

Main Results:

• The patient presented with large abdominal ascites and elevated serum CA-125 and RF levels.
• Biopsy confirmed peritoneal tuberculosis, ruling out malignancy.
• This case represents a rare instance of combined elevation of CA-125 and RF in peritoneal tuberculosis.

Conclusions:

• Peritoneal tuberculosis can present with elevated serum CA-125 and RF, complicating diagnosis.
• Tuberculosis infection should be considered in patients with unexplained ascites and elevated tumor markers.
• Physicians must maintain a high index of suspicion for peritoneal tuberculosis to prevent misdiagnosis and unnecessary procedures.