Female genital tract tuberculosis presenting as ovarian cancer
A 20-year-old primiparous woman was admitted to the department of gynecology at Ghaem University Hospital, in March 2003. She complained of painful abdominal distension and weight loss of approximately nine kilograms since the previous year. She had irregular menstruation and hypomenorrhea. Her past medical history was not remarkable, except for a pulmonary TB in her brother two years earlier, for which he completed the treatment course.\nOn admission, her vital signs were normal but the physical examination demonstrated a palpable pelvic mass (22 × 24 cm) with no tenderness. Ultrasound showed multiple myoma in the uterus and a large, multi-septated mass with internal echoes in the left ovary which suggested mucinous cystadenocarcinoma. Her biochemical profile, complete blood counts and chest X-ray were normal. She had a negative TST.\nUpon laparotomy, one could not enter the abdominal cavity. There were disseminated nodules covering the peritoneum of the parietal wall. During surgery, we cannot find ovarian mass and biopsy specimens of peritoneal nodules were taken. Pathologist reported chronic granulomatous inflammation suggestive of tuberculosis. The patient was treated with standard, anti-tuberculosis treatment. One year later, she had no signs of the disease.