Piura Benjamin, Rabinovich Alex, Leron Elad, Yanai-Inbar Ilana, Mazor Moshe
Unit of Gynecologic Oncology, Soroka Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 151, 84101, Beer-Sheva, Israel.
Eur J Obstet Gynecol Reprod Biol. 2003 Oct 10;110(2):230-4. doi: 10.1016/s0301-2115(03)00101-5.
To document women with peritoneal tuberculosis mimicking ovarian malignancy and to review pertinent literature.
The records of women with peritoneal tuberculosis who were managed at the Soroka Medical Center, Beer-Sheva, Israel between January 2000 and December 2001 were reviewed.
Four patients with peritoneal tuberculosis mimicking ovarian malignancy were encountered. Two presented with the classical symptomatology of advanced-stage ovarian carcinoma including ascites, abdominopelvic masses and elevated serum CA-125, and two presented with lower abdominal pain and adnexal mass. Laparoscopy in one patient and laparotomy in three patients revealed peritoneal tuberculosis and no malignancy. Of the three patients who had laparotomy, two underwent unnecessary extended surgery including total hysterectomy, bilateral salpingo-oophorectomy, omentectomy and bilateral pelvic lymphadenectomy, and one had conservative surgery including unilateral salpingo-oophorectomy. All patients were postoperatively treated with quadruple anti-tuberculosis chemotherapy.
Medical awareness of peritoneal tuberculosis is still lacking and many women with this disease are initially thought to have ovarian malignancy and undergo unnecessary extended surgery. Laparoscopy including biopsies seems to be a sufficient and safe method to provide diagnosis of peritoneal tuberculosis. If laparoscopy is not feasible, laparotomy should be performed. If no malignancy is detected and the diagnosis of peritoneal tuberculosis is confirmed, unnecessary extended surgery is avoided and anti-tuberculosis treatment is started.
记录表现为卵巢恶性肿瘤的腹膜结核女性患者，并回顾相关文献。
回顾了2000年1月至2001年12月期间在以色列贝尔谢巴索罗卡医疗中心接受治疗的腹膜结核女性患者的病历。
遇到4例表现为卵巢恶性肿瘤的腹膜结核患者。2例表现为晚期卵巢癌的典型症状，包括腹水、腹盆腔肿块和血清CA - 125升高，2例表现为下腹痛和附件肿块。1例患者接受了腹腔镜检查，3例患者接受了剖腹手术，结果显示为腹膜结核而非恶性肿瘤。在接受剖腹手术的3例患者中，2例接受了不必要的扩大手术，包括全子宫切除术、双侧输卵管卵巢切除术、大网膜切除术和双侧盆腔淋巴结切除术，1例接受了保守手术，包括单侧输卵管卵巢切除术。所有患者术后均接受四联抗结核化疗。
对腹膜结核的医学认识仍然不足，许多患有这种疾病的女性最初被认为患有卵巢恶性肿瘤并接受了不必要的扩大手术。包括活检在内的腹腔镜检查似乎是诊断腹膜结核的一种充分且安全的方法。如果腹腔镜检查不可行，则应进行剖腹手术。如果未检测到恶性肿瘤且腹膜结核诊断得到证实，则应避免不必要的扩大手术并开始抗结核治疗。
