The Hidden Culprit: Abdominal Tuberculosis Masquerading as Ovarian Cancer in a 22-Year-Old Woman

TL;DR

A 22-year-old woman's abdominal tuberculosis was initially mistaken for ovarian cancer, highlighting the difficulty in diagnosing rare conditions.

Contribution

This case emphasizes the need to consider abdominal TB as a differential diagnosis for adnexal masses and ascites.

Findings

Abdominal TB can mimic ovarian cancer with ascites, adnexal mass, and elevated CA-125 levels.

Diagnosis requires histopathological and PCR testing, as imaging and tumor markers are insufficient.

Multispecialty evaluations are often needed due to the complexity of abdominal TB.

Abstract

Abdominal tuberculosis (TB) is a rare extrapulmonary manifestation of TB in Europe. It may resemble ovarian cancer, especially when ascites, an adnexal mass, and elevated CA-125 levels are present. This case report aims to underline the significance of considering abdominal TB as a differential diagnosis when evaluating ascites with an adnexal mass. The presence of an adnexal mass and ascites should prompt consideration of a TB origin among the possible causes. This case highlights a significant diagnostic challenge, with delays in both diagnosis and management. The patient was evaluated across six specialities (Accident & Emergency, Acute Medicine, Gynaecology, Gynae-Oncology, Infectious Diseases, and Respiratory Medicine), illustrating the complexity and multisystem involvement that contributed to the prolonged diagnostic pathway. Diagnosis of abdominal TB can be challenging and time-consuming. Imaging and tumour markers alone are insufficient. Definitive diagnosis often requires histopathological examination and PCR testing to confirm the presence and nature of the disease.

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