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Erschienen in: Archives of Gynecology and Obstetrics 6/2010

01.12.2010 | General Gynecology

Peritoneal tuberculosis in premenopausal patients with elevated serum CA 125

verfasst von: Ali Naki Ulusoy, Ilhan Karabicak, Kadir Dicle, Mehmet Kefeli, Migraci Tosun, Mehmet Cetinkaya, Tayfun Alper, Cazip Ustun

Erschienen in: Archives of Gynecology and Obstetrics | Ausgabe 6/2010

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Abstract

Introduction

Peritoneal tuberculosis predominantly involves the omentum, intestinal tract, liver, spleen, and genitourinary tract and occurs in 1–4% of patients with pulmonary tuberculosis. Peritoneal tuberculosis may mimic a pelvic mass in imaging studies and also may increase CA-125 levels. Peritoneal tuberculosis may also produce massive ascites, and intraperitoneal gross appearance might be similar to the peritoneal carcinomatosis. Therefore, peritoneal tuberculosis is often confused with advanced-stage epithelial carcinoma because of similar clinical, radiologic, and laboratory findings and later intraoperative findings.

Materials and methods

The pathology records between January 2000 and August 2008 were retrospectively reviewed at 19 Mayis University Hospital. Twenty-two patients were found to have peritoneal caseating necrosis. A total of 13 out of 22 patients were found to have high CA 125 level.

Results

Among these 13 patients, 8 patients received/are receiving anti-tuberculous therapy after they were incidentally diagnosed with peritoneal tuberculosis.

Conclusion

Increased CA 125 levels should be evaluated carefully prior to aggressive surgical approach, especially in premenopausal women and frozen section evaluation should be done before extensive surgical procedure if there is any suspicion.
Literatur
1.
Zurück zum Zitat Koc S, Beydilli G, Tulunay G, Ocalan R, Boran N, Ozgul N, Kose MF, Erdogan Z (2006) Peritoneal tuberculosis mimicking advanced ovarian cancer: a retrospective review of 22 cases. Gynecol Oncol 103:565–569CrossRefPubMed Koc S, Beydilli G, Tulunay G, Ocalan R, Boran N, Ozgul N, Kose MF, Erdogan Z (2006) Peritoneal tuberculosis mimicking advanced ovarian cancer: a retrospective review of 22 cases. Gynecol Oncol 103:565–569CrossRefPubMed
2.
Zurück zum Zitat Hopewell PC (1994) Overview of clinical tuberculosis. In: Bloom BR (ed) Tuberculosis, pathogenesis, protection and control, 1st edn, Chap 3. American Society for Microbiology, Washington, DC, pp 25–46 Hopewell PC (1994) Overview of clinical tuberculosis. In: Bloom BR (ed) Tuberculosis, pathogenesis, protection and control, 1st edn, Chap 3. American Society for Microbiology, Washington, DC, pp 25–46
3.
Zurück zum Zitat Sinan T, Sheikh M, Ramadan S, Sahwney S, Behbehani A (2002) CT features in abdominal tuberculosis: 20 years experience. BMC Med Imaging 2:3CrossRefPubMed Sinan T, Sheikh M, Ramadan S, Sahwney S, Behbehani A (2002) CT features in abdominal tuberculosis: 20 years experience. BMC Med Imaging 2:3CrossRefPubMed
4.
Zurück zum Zitat Mahdavi A, Malviya VK, Herschman BR (2002) Peritoneal tuberculosis disguised as ovarian cancer: an emerging clinical challenge. Gynecol Oncol 84:167–170CrossRefPubMed Mahdavi A, Malviya VK, Herschman BR (2002) Peritoneal tuberculosis disguised as ovarian cancer: an emerging clinical challenge. Gynecol Oncol 84:167–170CrossRefPubMed
5.
Zurück zum Zitat Engin G, Acunaş B, Acunaş G, Tunaci M (2000) Imaging of extrapulmonary tuberculosis. Radiographics 20:471–488PubMed Engin G, Acunaş B, Acunaş G, Tunaci M (2000) Imaging of extrapulmonary tuberculosis. Radiographics 20:471–488PubMed
6.
Zurück zum Zitat Bilgin T, Karabay A, Dolar E, Develioğlu OH (2001) Peritoneal tuberculosis with pelvic abdominal mass, ascites and elevated CA 125 mimicking advanced ovarian carcinoma: a series of 10 cases. Int J Gynecol Cancer 11:290–294CrossRefPubMed Bilgin T, Karabay A, Dolar E, Develioğlu OH (2001) Peritoneal tuberculosis with pelvic abdominal mass, ascites and elevated CA 125 mimicking advanced ovarian carcinoma: a series of 10 cases. Int J Gynecol Cancer 11:290–294CrossRefPubMed
7.
Zurück zum Zitat Tan O, Luchansky E, Rosenman S, Pua T, Azodi M (2009) Peritoneal tuberculosis with elevated serum Ca-125 level mimicking advanced stage ovarian cancer: a case report. Arch Gynecol Obstet 280:333–335CrossRefPubMed Tan O, Luchansky E, Rosenman S, Pua T, Azodi M (2009) Peritoneal tuberculosis with elevated serum Ca-125 level mimicking advanced stage ovarian cancer: a case report. Arch Gynecol Obstet 280:333–335CrossRefPubMed
8.
Zurück zum Zitat Ibrahim G, Gelzayd B, DeMatia F, Maas L (1999) CA-125 tumor-associated antigen in a patient with tuberculous peritonitis. South Med J 92:1103–1104CrossRefPubMed Ibrahim G, Gelzayd B, DeMatia F, Maas L (1999) CA-125 tumor-associated antigen in a patient with tuberculous peritonitis. South Med J 92:1103–1104CrossRefPubMed
9.
Zurück zum Zitat Dursun P, Ersoz S, Gultekin M, Aksan G, Yüce K, Ayhan A (2006) Disseminated peritoneal tuberculosis mimicking advanced-stage endodermal sinus tumor: a case report. Int J Gynecol Cancer 16:303–307CrossRefPubMed Dursun P, Ersoz S, Gultekin M, Aksan G, Yüce K, Ayhan A (2006) Disseminated peritoneal tuberculosis mimicking advanced-stage endodermal sinus tumor: a case report. Int J Gynecol Cancer 16:303–307CrossRefPubMed
10.
Zurück zum Zitat Chow KM, Chow VCY, Szeto CC (2003) Indication for peritoneal biopsy in tuberculous peritonitis. Am J Surg 185:567–573CrossRefPubMed Chow KM, Chow VCY, Szeto CC (2003) Indication for peritoneal biopsy in tuberculous peritonitis. Am J Surg 185:567–573CrossRefPubMed
11.
Zurück zum Zitat Sheth SS (1996) Elevated CA 125 in advanced abdominal or pelvic tuberculosis. Int J Gynaecol Obstet 52:167–171CrossRefPubMed Sheth SS (1996) Elevated CA 125 in advanced abdominal or pelvic tuberculosis. Int J Gynaecol Obstet 52:167–171CrossRefPubMed
12.
Zurück zum Zitat Sevinc A, Adli M, Kalender ME, Camci C (2007) Benign causes of increased serum CA-125 concentration. Lancet Oncol 8:1054–1055CrossRefPubMed Sevinc A, Adli M, Kalender ME, Camci C (2007) Benign causes of increased serum CA-125 concentration. Lancet Oncol 8:1054–1055CrossRefPubMed
13.
Zurück zum Zitat Barbieri RL, Niloff JM, Bast RC Jr, Scaetzl E, Kistner RW, Knapp RC (1986) Elevated serum concentrations of CA-125 in patients with advanced endometriosis. Fertil Steril 45:630–634PubMed Barbieri RL, Niloff JM, Bast RC Jr, Scaetzl E, Kistner RW, Knapp RC (1986) Elevated serum concentrations of CA-125 in patients with advanced endometriosis. Fertil Steril 45:630–634PubMed
14.
Zurück zum Zitat Ulusoy M, Ayer A, Feyizoğlu H, Alan MS, Keskin K, Gürkan Y, Cengiz I, Kuyubaşi Z (2005) Tuberculous peritonitis and elevated serum CA 125 in a patient with chronic renal failure. Turk J Gastroenterol 16:117–118PubMed Ulusoy M, Ayer A, Feyizoğlu H, Alan MS, Keskin K, Gürkan Y, Cengiz I, Kuyubaşi Z (2005) Tuberculous peritonitis and elevated serum CA 125 in a patient with chronic renal failure. Turk J Gastroenterol 16:117–118PubMed
15.
Zurück zum Zitat Sheikh HH (1996) Infertility due to genital tuberculosis. J Am Assoc Gynecol Laparosc 3:453–459CrossRefPubMed Sheikh HH (1996) Infertility due to genital tuberculosis. J Am Assoc Gynecol Laparosc 3:453–459CrossRefPubMed
16.
Zurück zum Zitat Nezar M, Goda H, El-Negery M, El-Saied M, Wahab AA, Badawy AM (2009) Genital tract tuberculosis among infertile women: an old problem revisited. Arch Gynecol Obstet 280:787–791CrossRefPubMed Nezar M, Goda H, El-Negery M, El-Saied M, Wahab AA, Badawy AM (2009) Genital tract tuberculosis among infertile women: an old problem revisited. Arch Gynecol Obstet 280:787–791CrossRefPubMed
17.
Zurück zum Zitat Yapar EG, Ekici E, Karasahin E, Gökmen O (1995) Sonographic features of tuberculous peritonitis with female genital tract tuberculosis. Ultrasound Obstet Gynecol 6:121–125CrossRefPubMed Yapar EG, Ekici E, Karasahin E, Gökmen O (1995) Sonographic features of tuberculous peritonitis with female genital tract tuberculosis. Ultrasound Obstet Gynecol 6:121–125CrossRefPubMed
18.
Zurück zum Zitat Ha HK, Jung JI, Lee MS, Choi BG, Lee MG, Kim YH, Kim PN, Auh YH (1996) CT differentiation of tuberculous peritonitis and peritoneal carcinomatosis. AJR Am J Roentgenol 167:743–748PubMed Ha HK, Jung JI, Lee MS, Choi BG, Lee MG, Kim YH, Kim PN, Auh YH (1996) CT differentiation of tuberculous peritonitis and peritoneal carcinomatosis. AJR Am J Roentgenol 167:743–748PubMed
19.
Zurück zum Zitat Kramer BS, Gohagan J, Prorok PC, Smart C (1993) A National Cancer Institute sponsored screening trial for prostatic, lung, colorectal, and ovarian cancers. Cancer 71:589–593CrossRefPubMed Kramer BS, Gohagan J, Prorok PC, Smart C (1993) A National Cancer Institute sponsored screening trial for prostatic, lung, colorectal, and ovarian cancers. Cancer 71:589–593CrossRefPubMed
20.
Zurück zum Zitat Simsek H, Kadayifci A, Okan E (1996) Importance of serum CA 125 levels in malignant peritoneal mesothelioma. Tumour Biol 17:1–4CrossRefPubMed Simsek H, Kadayifci A, Okan E (1996) Importance of serum CA 125 levels in malignant peritoneal mesothelioma. Tumour Biol 17:1–4CrossRefPubMed
21.
Zurück zum Zitat Nordhock GT, Kolk AH, Bjunc G et al (1994) Sensitivity and specificity or PCR for detection of mycobacterium tuberculosis: a blind comparison study among seven laboratories. J Clin Microbiol 32:277–284 Nordhock GT, Kolk AH, Bjunc G et al (1994) Sensitivity and specificity or PCR for detection of mycobacterium tuberculosis: a blind comparison study among seven laboratories. J Clin Microbiol 32:277–284
22.
Zurück zum Zitat Akcan Y, Tuncer S, Hayran M, Sungur A, Unal S (1997) PCR on disseminated tuberculosis in bone marrow and liver biopsy specimens: correlation to histopathological and clinical diagnosis. Scand J Infect Dis 29:271–274CrossRefPubMed Akcan Y, Tuncer S, Hayran M, Sungur A, Unal S (1997) PCR on disseminated tuberculosis in bone marrow and liver biopsy specimens: correlation to histopathological and clinical diagnosis. Scand J Infect Dis 29:271–274CrossRefPubMed
23.
Zurück zum Zitat Voigt MD, Kalvaria I, Trey C, Berman P, Lombard C, Kirsch RE (1989) Diagnostic value of ascites adenosine deaminase in tuberculous peritonitis. Lancet 1:751–754CrossRefPubMed Voigt MD, Kalvaria I, Trey C, Berman P, Lombard C, Kirsch RE (1989) Diagnostic value of ascites adenosine deaminase in tuberculous peritonitis. Lancet 1:751–754CrossRefPubMed
24.
Zurück zum Zitat Thakur V, Mukherjee U, Kumar K (2001) Elevated serum cancer antigen 125 levels in advanced abdominal tuberculosis. Med Oncol 18:289–291CrossRefPubMed Thakur V, Mukherjee U, Kumar K (2001) Elevated serum cancer antigen 125 levels in advanced abdominal tuberculosis. Med Oncol 18:289–291CrossRefPubMed
25.
Zurück zum Zitat Mas MR, Cömert B, Sağlamkaya U, Yamanel L, Kuzhan O, Ateşkan U, Kocabalkan F (2000) CA-125; a new marker for diagnosis and follow-up of patients with tuberculous peritonitis. Dig Liver Dis 32:595–597CrossRefPubMed Mas MR, Cömert B, Sağlamkaya U, Yamanel L, Kuzhan O, Ateşkan U, Kocabalkan F (2000) CA-125; a new marker for diagnosis and follow-up of patients with tuberculous peritonitis. Dig Liver Dis 32:595–597CrossRefPubMed
26.
Zurück zum Zitat Sakorafas GH, Ntavatzikos A, Konstantiadou I, Karamitopoulou E, Kavatha D, Peros G (2009) Peritoneal tuberculosis in pregnancy mimicking advanced ovarian cancer: a plea to avoid hasty, radical and irreversible surgical decisions. Int J Infect Dis 13:270–272CrossRef Sakorafas GH, Ntavatzikos A, Konstantiadou I, Karamitopoulou E, Kavatha D, Peros G (2009) Peritoneal tuberculosis in pregnancy mimicking advanced ovarian cancer: a plea to avoid hasty, radical and irreversible surgical decisions. Int J Infect Dis 13:270–272CrossRef
Metadaten
Titel
Peritoneal tuberculosis in premenopausal patients with elevated serum CA 125
verfasst von
Ali Naki Ulusoy
Ilhan Karabicak
Kadir Dicle
Mehmet Kefeli
Migraci Tosun
Mehmet Cetinkaya
Tayfun Alper
Cazip Ustun
Publikationsdatum
01.12.2010
Verlag
Springer-Verlag
Erschienen in
Archives of Gynecology and Obstetrics / Ausgabe 6/2010
Print ISSN: 0932-0067
Elektronische ISSN: 1432-0711
DOI
https://doi.org/10.1007/s00404-009-1283-x

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