Department of General Surgery, 19 Mayis University Medical Faculty, Samsun, Turkey.
Arch Gynecol Obstet. 2010 Dec;282(6):639-42. doi: 10.1007/s00404-009-1283-x. Epub 2009 Nov 29.
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.
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.
Among these 13 patients, 8 patients received/are receiving anti-tuberculous therapy after they were incidentally diagnosed with peritoneal tuberculosis.
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.
腹膜结核主要累及大网膜、肠道、肝脏、脾脏和泌尿生殖道，占肺结核患者的 1-4%。腹膜结核在影像学检查中可能类似于盆腔肿块，也可能会增加 CA-125 水平。腹膜结核还可能产生大量腹水，腹腔内大体外观可能与腹膜癌病相似。因此，由于类似的临床、影像学和实验室发现以及术后术中发现，腹膜结核常与晚期上皮癌混淆。
在 19 日 Mayis 大学医院对 2000 年 1 月至 2008 年 8 月的病理记录进行了回顾性分析。共发现 22 例腹膜干酪样坏死患者。在这 22 例患者中，有 13 例 CA 125 水平升高。
在这 13 例患者中，有 8 例在偶然诊断为腹膜结核后接受/正在接受抗结核治疗。
在采取积极的手术方法之前，应仔细评估 CA 125 水平升高，尤其是在绝经前妇女中，如果有任何怀疑，应在进行广泛手术前进行冰冻切片评估。
