Volume 29, Issue 166, December 2025

Ovarian cancer or extraperitoneal tuberculosis? Is a fast and pertinent diagnosis possible?

Miłosz Włodarczyk¹, Patrycja Wójcikiewicz^1♦, Gabriela Zakrzewska¹, Maria Materek¹, Kajetan Kowalski², Rafał Tarkowski3, Krzysztof Kułak³

¹Student’s Scientific Association at the 1st Chair and Department of Oncological Gynecology and Gynecology, Medical University of Lublin, Staszic 16 St., 20-081 Lublin, Poland
²Student’s Scientific Association of Urology at the Department of General, Oncological and Functional Urology, Medical University of Warsaw, Lindley 4 St., 02-005 Warsaw, Poland
³1st Chair and Department of Oncological Gynaecology and Gynaecology, Medical University of Lublin, Staszic 16 St., 20-081 Lublin, Poland

^♦Corresponding Author
Patrycja Wójcikiewicz, Student’s Scientific Association at the 1st Chair and Department of Oncological Gynecology and Gynecology, Medical University of Lublin, Staszic 16 St., 20-081 Lublin, Poland,

ABSTRACT

Extrapulmonary tuberculosis mimicking ovarian cancer poses a significant diagnostic problem. The intraoperative examinations determine diagnosis. Antituberculous drugs are initiated far too late. There is no factor differentiating these two diseases. Nonspecific symptoms such as chronic lower abdominal pain, flatulence, nausea, vomiting, loss of appetite, and weight are common to both conditions, but do not raise the suspicion of tuberculosis in the first instance. Genital bleeding, fever, and increasing ascites, especially in patients with risk factors, should prompt a widening of the diagnosis to include a possible TB aetiology. An increase in CA-125 levels is also not tumour-specific. The presence of a lymphocytic exudate in the peritoneal fluid, the absence of malignant cells, and elevated ADA levels are essential clues in the diagnosis of peritoneal tuberculosis, even in the absence of bacteriological confirmation. A review of the available literature was conducted to identify factors that could suggest tuberculosis in these patients and allow for a precise preoperative diagnosis, thereby accelerating the initiation of anti-tuberculosis therapy. Laparoscopy enables the collection of biopsy samples and facilitates an accurate histopathological diagnosis. However, the question remains whether a tuberculous aetiology can be considered earlier to allow for timely treatment.

Keywords: tuberculosis, ovarian cancer, extraperitoneal tuberculosis

Medical Science, 2025, 29, e221ms3732

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DOI: https://doi.org/10.54905/disssi.v29i166.e221ms3732

Published: 3 December 2025