GENERAL GYNECOLOGY Abdomino-peritoneal tuberculosis masquerading as ovarian cancer: a retrospective study of 26 cases Jai Bhagwan Sharma • Sunesh K. Jain • Mohanraj Pushparaj • Kallol K. Roy • Neena Malhotra • Vijay Zutshi • Shalini Rajaram Received: 5 August 2009 / Accepted: 9 November 2009 / Published online: 1 December 2009 Ó Springer-Verlag 2009 Abstract Purpose Evaluation of clinical, laboratory, and operative findings in women of abdomino-pelvic tuberculosis undergoing laparotomy for suspected ovarian cancer. Methods A retrospective analysis of 26 women who underwent laparotomy for ovarian cancer and found to have abdomino-pelvic tuberculosis in three hospitals of Delhi. Results The mean age was 34.65 years. Symptoms were menstrual dysfunction in 12 (46.2%), abdominal distension (8 women, 30.7%), abdominal pain (26 women, 100%), abdominal mass (5 women, 19.2%). Mean and standard deviation (SD) of Ca-125 levels were 594.22 ± 770.07. The mean ± SD of right and left tubovarian mass being 5.82 ± 3.94 cm and 5.81 ± 3.21 cm, respectively. Abdominal hysterectomy was done in 4 (15.4%) cases, right ovariotomy in 5 (19.2%), left Ovariotomy in 6 (23.1%), biopsies from right ovary 11 (42.3%), left ovary 7 (26.9%), omentum 10 (38.5%), peritoneum in 15 (57.7%). Tuberculous granuloma and AFB stain on histopathology were observed in all cases. Conclusion Peritoneal tuberculosis with abdomino-pelvic masses was difficult to differentiate from ovarian cancer. Antitubercular drugs are the treatment of choice and complete surgery being difficult and hazardous should be avoided. Keywords Peritoneal tuberculosis Á Ovarian cancer Á Malignancy Á Ca-125 Introduction Tuberculosis caused by Mycobacterium tuberculosis is a major public health problem in developing countries and was declared a global emergency by World Health Organi- zation (WHO) in 1993 [1]. Human immunodeficiency virus (HIV) co-infection especially in sub-Saharan Africa has further compounded the problem [2]. More liberal migration from high risk to low risk areas has been responsible for increased incidence in North America and Western Europe [2]. The problem has become compounded by the emer- gence of multidrug resistant mutant tuberculosis (MDR) and extreme drug resistant TB (XDR) which are caused by poor case management and are a cause of serious concern throughout the world [2]. Directly observed treatment short course (DOTS) strategy in which the onus of treatment falls on the health provider with the quality assured complete drug therapy is given to all the patients free of cost under government programs and is an effective strategy as has been the experience of the Revised National Tuberculosis Control Program (RNTCP) of India with 72% case detection rate, 86% treatment success rate and a sevenfold reduction in death rate (from 29 to 4%) with DOTS strategy [3, 4]. J. B. Sharma Á S. K. Jain Á M. Pushparaj Á K. K. Roy Á N. Malhotra Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, New Delhi 110029, India V. Zutshi Department of Obstetrics and Gynecology, Lok Nayak Hospital, New Delhi 110002, India S. Rajaram Department of Obstetrics and Gynecology, University College of Medical Science and GTB Hospital, New Delhi, India J. B. Sharma (&) AI/161, Azad Apartments, Sri Aurobindo Marg, New Delhi 110016, India e-mail: jbsharma2000@gmail.com 123 Arch Gynecol Obstet (2010) 282:643–648 DOI 10.1007/s00404-009-1295-6