Diagnostic dilemma of abdominopelvic tuberculosis: a series of 20 cases

被引:16
作者
Xia Xi [1 ]
Li Shuang [1 ]
Wang Dan [1 ]
Hu Ting [1 ]
Meng Yu Han [1 ]
Cao Ying [1 ]
Mei Quan [1 ]
Sun ChaoYang [1 ]
Chen ZhiLan [1 ]
Feng Cui [1 ]
Cao Ming [1 ]
Jian Feng Zhou [1 ]
Wang Shi Xuan [1 ]
Yun Ping Lu [1 ]
Ding Ma [1 ]
机构
[1] Huazhong Univ Sci & Technol, Tongji Med Coll, Tongji Hosp, Canc Biol Res Ctr, Wuhan 430030, Hubei, Peoples R China
基金
美国国家科学基金会;
关键词
Abdominopelvic tuberculosis; Ovarian cancer; Diagnosis; Laparotomy; Frozen section; ABDOMINAL-WALL METASTASES; ADVANCED OVARIAN-CANCER; PERITONEAL TUBERCULOSIS; PELVIC TUBERCULOSIS; LAPAROSCOPY;
D O I
10.1007/s00432-010-0842-7
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
To establish more effective diagnostic procedures to identify the characteristic features of abdominopelvic tuberculosis (APTB) mimicking advanced ovarian cancer. A retrospective review of 20 cases of APTB mimicking advanced ovarian cancer was undertaken. The mean age of the patients was 28.9 +/- A 10.8 years. The main clinical manifestations were abdominal pain (45%) and distention (45%). CA125 level was elevated in 18 cases (90.0%). Pelvic mass in 18 patients (90.0%) and ascites in 12 patients (60.0%) were detected by using abdominal US. The bacteriologic cultures and cytological studies were all negative (10 cases, 100%). Laparotomy (17 cases) and laparoscopic evaluation (1 case) was performed with the presumptive diagnosis of advanced ovarian cancer except for 2 patients treated with diagnostic anti-TB chemotherapy. The common intra-operative findings were miliary nodules (14 cases, 77.8%) and widespread adhesion (10 cases, 55.6%). Intra-operative frozen section was obtained in 10 cases, and the typical tuberculosis tubercles were detected in all cases. APTB should be considered in all cases with pelvic mass, ascites and high levels of CA125, although clinical features and laboratory results specifically indicate neither ovarian malignancy nor APTB. Diagnostic laparotomy is a direct and safe method. To avoid extended surgery, the cases with APTB can be diagnosed through intra-operative frozen section in conjunction with clinical features.
引用
收藏
页码:1839 / 1844
页数:6
相关论文
共 22 条
[1]   Tuberculosis in the belly: A review of forty-six cases involving the gastrointestinal tract and peritoneum [J].
Al Muneef, M ;
Memish, Z ;
Al Mahmoud, S ;
Al Sadoon, S ;
Bannatyne, R ;
Khan, Y .
SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY, 2001, 36 (05) :528-532
[2]   Abdominopelvic tuberculosis simulating disseminated ovarian carcinoma with elevated CA-125 level: report of two cases [J].
Barutcu, O ;
Erel, HE ;
Saygili, E ;
Yildirim, T ;
Torun, D .
ABDOMINAL IMAGING, 2002, 27 (04) :465-470
[3]  
BHANSALI SK, 1977, AM J GASTROENTEROL, V67, P324
[4]   Clinical presentation of abdominal tuberculosis in HIV seronegative adults [J].
Bolukbas, C ;
Bolukbas, FF ;
Kendir, T ;
Dalay, RA ;
Akbayir, N ;
Sokmen, MH ;
Ince, AT ;
Guran, M ;
Ceylan, E ;
Kilic, G ;
Ovunc, O .
BMC GASTROENTEROLOGY, 2005, 5 (1)
[5]  
dePaz FN, 1996, AM J GASTROENTEROL, V91, P1660
[6]   ABDOMINAL-WALL METASTASES FROM OVARIAN-CANCER AFTER LAPAROSCOPY [J].
GLEESON, NC ;
NICOSIA, SV ;
MARK, JE ;
HOFFMAN, MS ;
CAVANAGH, D .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1993, 169 (03) :522-523
[7]   Peritoneal tuberculosis versus advanced ovarian cancer: A diagnostic dilemma [J].
Groutz, A ;
Carmon, E ;
Gat, A .
OBSTETRICS AND GYNECOLOGY, 1998, 91 (05) :868-868
[8]  
KARLAN BY, 1995, CANCER-AM CANCER SOC, V76, P2011, DOI 10.1002/1097-0142(19951115)76:10+<2011::AID-CNCR2820761318>3.0.CO
[9]  
2-L
[10]   Peritoneal tuberculosis mimicking advanced ovarian cancer: A retrospective review of 22 cases [J].
Koc, Sevgi ;
Beydilli, Gulay ;
Tulunay, Gokhan ;
Ocalan, Reyhan ;
Boran, Nurettin ;
Ozgul, Nejat ;
Kose, M. Faruk ;
Erdogan, Zuhal .
GYNECOLOGIC ONCOLOGY, 2006, 103 (02) :565-569