Bouchaib Allae Eddine, Drissi Jihad, Babahabib Abdellah, Elhassani Moulay El Mehdi, Kouach Jaouad
Service de Gynécologie-Obstétrique, Hôpital Militaire d'Instruction Mohamed V, Rabat, Maroc.
Pan Afr Med J. 2022 Nov 9;43:130. doi: 10.11604/pamj.2022.43.130.35899. eCollection 2022.
Pseudotumoral peritoneal tuberculosis is uncommon, but its incidence is high in endemic areas. Given the great radioclinical similarity between pseudotumoral peritoneal tuberculosis and ovarian cancer, we conducted a retrospective study in the Department of Obstetrics and Gynaecology of the Military Hospital of Instruction Mohammed V in Rabat, involving 14 cases (n= 14) of pseudotumoral peritoneal tuberculosis in order to illustrate the problem of differential diagnosis. All other extra-pelvic locations were excluded, the average age of our patients was 33.4 years with a maximum of cases in the 16-40 years group: 71% (n=10/14). Common clinical symptoms of this particular form of peritoneal tuberculosis were abdominal pain: 100% (n=14/14) associated with abdominopelvic mass: 71% (n=10/14) and ascites: 64% (n=09/14) mimicking peritoneal carcinosis of ovarian origin, especially since both pathologies progressed in a context of impaired general condition. Diagnosis was based on invasive laparoscopic examinations: 35% (n=05/14) or laparotomy: 57% (n=08/14) with biopsies. Indeed, only histological examination can help to establish definitive Corriger diagnosis, in the majority of cases. Therapeutic management of our patients was based on medical treatment, according to the national tuberculosis control program, and surgical treatment. The use of invasive explorations is often unavoidable before initiating any anti-bacillary treatment. Patients´ outcome under specific treatment is favorable, the prognosis of fertility is engaged in young women.
假性肿瘤性腹膜结核并不常见，但在流行地区其发病率较高。鉴于假性肿瘤性腹膜结核与卵巢癌在放射临床方面极为相似，我们在拉巴特穆罕默德五世军事教学医院妇产科进行了一项回顾性研究，纳入了14例假性肿瘤性腹膜结核病例（n = 14），以阐明鉴别诊断问题。排除了所有其他盆腔外部位，我们患者的平均年龄为33.4岁，16 - 40岁组病例最多：71%（n = 10/14）。这种特殊形式的腹膜结核常见的临床症状为腹痛：100%（n = 14/14），伴有腹盆腔肿块：71%（n = 10/14）和腹水：64%（n = 9/14），酷似卵巢来源的腹膜癌，尤其是因为这两种疾病均在全身状况受损的情况下进展。诊断基于侵入性腹腔镜检查：35%（n = 5/14）或剖腹手术：57%（n = 8/14）并进行活检。实际上，在大多数情况下，只有组织学检查有助于确立明确的诊断。我们患者的治疗管理基于国家结核病控制规划的药物治疗和手术治疗。在开始任何抗结核治疗之前，通常不可避免地要进行侵入性探查。在特定治疗下患者的预后良好，年轻女性的生育预后受到影响。
