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Neutrophil-Predominant Peritoneal Tuberculosis With Salpingitis Mimicking Ovarian Cancer: A Case Report
Noura Almarzooqi1, Radwa Kafafi1, Aymen Abbas1
1Internal Medicine, Sheikh Khalifa Medical City, Abu Dhabi, ARE.
Cureus
|August 18, 2025
Summary
Abdominal tuberculosis can mimic ovarian cancer in young women, leading to diagnostic challenges. Early and accurate diagnosis is crucial for effective treatment of this extrapulmonary form of tuberculosis.
Area of Science:
- Infectious Diseases
- Gastroenterology
- Gynecologic Oncology
Background:
- Tuberculosis (TB), caused by Mycobacterium tuberculosis, is a leading infectious cause of mortality globally.
- Abdominal TB, a form of extrapulmonary TB (EPTB), often presents with nonspecific symptoms and can be mistaken for other conditions.
- Distinguishing abdominal TB from ovarian malignancy is critical, especially in young women with similar clinical presentations.
Observation:
- A 20-year-old woman presented with symptoms suggestive of malignancy, including fever, night sweats, vomiting, and elevated inflammatory markers.
- Initial imaging (ultrasound, CT) indicated ovarian masses and peritoneal involvement, raising suspicion for cancer.
- MRI revealed bilateral hydrosalpinx, and peritoneal fluid analysis confirmed Mycobacterium tuberculosis infection.
Findings:
- The case highlights the diagnostic challenges in differentiating abdominal TB from ovarian cancer due to overlapping clinical and imaging features.
- Elevated cancer antigen 125 levels, commonly associated with ovarian cancer, were observed in this patient with abdominal TB.
- Acid-fast bacillus culture of peritoneal fluid confirmed Mycobacterium tuberculosis as the causative agent.
Implications:
- This case underscores the importance of considering EPTB in the differential diagnosis of abdominal masses and ascites, even with initial findings suggestive of malignancy.
- Diagnostic laparoscopy with biopsy may be necessary for definitive diagnosis when imaging is inconclusive for suspected ovarian cancer and EPTB.
- Increased awareness and appropriate diagnostic workup are essential for timely management of abdominal TB, preventing potential misdiagnosis and treatment delays.
