An Indonesian female with peritoneal tuberculosis mimicking ovarium carcinoma: A rare case

Peritoneal tuberculosis is rare when patients with abdominal pain need to be considered for tuberculosis testing.

An Indonesian female, 19 years old, complained of abdominal pain and enlargement. Laboratory examination is abnormal, including thrombocytosis of 687,000/uL and Ca-125 of 3483 U/mL. Ultrasound and CT scan of the abdomen showed cystic lesions in the pelvic cavity, enlargement of the abdominal lymph nodes, and ascites. She was diagnosed with ovarian carcinoma. The patient underwent surgery and obtained nodules such as tuberculoma. Nodule biopsy results showed granulomatous inflammation. The patient was given anti-tuberculosis drug (ATD) category 1 for 2 months and continued with category 2 for 7 months (total 9 months of treatment). The prognosis showed improvement, and weight increased by 15 kg (from 40 kg to 55 kg).

The challenge of peritoneal tuberculosis is the absence of specific signs and symptoms. Therefore, tuberculosis testing must be considered if tuberculosis is endemic in patients with abdominal pain who do not show a good prognosis when treated according to the developed signs and symptoms.

Suspicion of tuberculosis infection should be evaluated in endemic tuberculosis because some tuberculosis infections, such as peritoneal tuberculosis, do not have specific signs and symptoms.