Female genital tract tuberculosis presenting as ovarian cancer
A 16-year-old virgin girl with the complaints of abdominal pain and weight loss was referred to the department of gynecology at Ghaem University Hospital, in July 2009. Her symptoms began six months ago and she lost over 10 kilograms of weight during this period. Her past medical history was not remarkable, except for the diagnosis of TB in her brother and sister, for which they had been treated one year ago. On admission, her vital signs were normal, but a 7 × 8 cm non-tender firms mass was found upon physical examination. Ultrasound showed a 39 × 116 cm cystic and multi-septated mass with irregular and thickened wall in the right adnexa suggesting an ovarian cancer. She had no abnormality on chest X-ray and TST was negative. CA- 125 level was 509 units per ml. Based on the clinical findings and Lab test results, an exploratory laparotomy was performed. There were severe adhesions. The frozen section examination of biopsy materials was strongly suspicious for TB. Standard anti-tuberculosis drugs were started and the patient was discharged from hospital. Upon her visit one year later, the abdominal mass was disappeared. She had no complaints and her ultrasound study was normal.