[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-327051-105":59,"doc-detail-327051-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","tuberculous-peritonitis-diagnosed-following-laparoscopic-examination-for-suspected-advanced-ovarian-cancer","Tuberculous peritonitis diagnosed following laparoscopic examination for suspected advanced ovarian cancer","","A BMJ case report describes a woman in her 50s with constipation, massive ascites, and multiple peritoneal nodules initially suggesting advanced ovarian cancer. Imaging showed abnormal PET-CT uptake in pleura, peritoneum, systemic lymph nodes, and bilateral ovaries, with elevated CA125. Diagnostic laparoscopy revealed diffuse nodular lesions and adhesions, and histopathology identified epithelioid granulomas and Langhans giant cells, confirming tuberculous peritonitis. The report emphasizes that TB peritonitis can mimic malignancy and preoperative diagnosis is often difficult, so it should be considered when intraoperative findings show disseminated nodular lesions.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/tuberculous-peritonitis-diagnosed-following-laparoscopic-examination-for-suspected-advanced-ovarian-cancer/327051/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/tuberculous-peritonitis-diagnosed-following-laparoscopic-examination-for-suspected-advanced-ovarian-cancer/327051.png","ImageObject",300,407,{"name":92,"@type":93},"Finn","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-28","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why was advanced ovarian cancer suspected in this case?","Question",{"text":112,"@type":113},"Massive ascites, multiple peritoneal nodules, and abnormal uptake on PET-CT with elevated CA125 led to suspicion of advanced ovarian cancer.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What diagnostic evidence confirmed tuberculous peritonitis?",{"text":117,"@type":113},"Histopathological examination of tissue from the right fallopian tube showed epithelioid granulomas and Langhans giant cells, leading to a diagnosis of TB.",{"name":119,"@type":110,"acceptedAnswer":120},"How could tuberculous peritonitis be mistaken for ovarian cancer?",{"text":121,"@type":113},"TB peritonitis can present with diffuse nodular lesions and ascites that resemble carcinomatous peritonitis, making preoperative differentiation difficult.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},327051,1790079927,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":24,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144},34359740700684,"https://ap-avatar.wpscdn.com/avatar/1f400023980c374ae676?_k=1777273430885731487","Case report  \nTuberculous peritonitis diagnosed following laparoscopic examination for suspected advanced ovarian cancer  \nMizuki Nonaka, Hiroaki Ishida  , Megumi Manrai, Akiko Takashima  \nDepartment of Obstetrics and Gynecology, Toho University Medical Center, Sakura, Japan  \nCorrespondence to  \nDr Hiroaki Ishida;  \n[ishida-04@sakura.med.toho-u](ishida-04@sakura.med.toho-u). [ac.jp](ac.jp)  \nAccepted 20 February 2024  \n© BMJ Publishing Group Limited 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.  \nTo cite: Nonaka M, Ishida H, Manrai M, et al. BMJ Case Rep 2024;17:e257973 . doi:10 . 1136/bcr-2023- 257973  \nSUMMARY  \nLaparoscopy for intra-abdominal exploration and tissue sampling is useful in advanced ovarian cancers, in which it is presumed to be difficult to achieve complete tumour reduction in the initial surgery. This is a report of a case of suspected advanced ovarian cancer in a patient, who underwent laparoscopic screening and was later pathologically diagnosed with tuberculous peritonitis. A woman in her 50s visited her local doctor with constipation. Since imaging showed massive ascites she was referred for further evaluation. We initially suspected advanced ovarian cancer due to the presence of massive ascites and multiple peritoneal nodules. However, histopathological examination indicated  \nthat the nodules were tubercles, and the patient was subsequently diagnosed with tuberculous peritonitis. It is important to be aware that tuberculosis peritonitis can be misdiagnosed or mistaken for advanced ovarian cancer. Preoperative diagnosis of tuberculous peritonitis is often difficult. Tuberculous peritonitis should be considered if intraoperative findings show diffuse nodular disseminated lesions.  \nBACKGROUND  \nLaparoscopy for intra-abdominal exploration and tissue sampling is useful in advanced ovarian cancers, in which it is presumed to be difficult to achieve complete tumour reduction in the initial surgery. In our hospital, in patients with massive ascites and intra-abdominal distention, complete resection cannot be expected during the initial surgery. Therefore, if the overall general health condition allows for the administration of general anaesthesia, an examination laparoscopy is performed as soon as possible, Here, we report a case of suspected advanced ovarian cancer in a patient, who underwent laparoscopic screening and was pathologically diagnosed with tuberculous peritonitis.  \nCASE PRESENTATION  \nA woman in her 50s with two pregnancies and two deliveries (G2P2) visited her local doctor with constipation. Her height was 150 cm, weight was 53 kg and body mass index was 23.6 kg/m2. Vitals before treatment were blood pressure 131/79 mm Hg, heart rate 92 times/min, respiratory rate 22 times/min, Spo2 96% and body temperature 35.9°C. She had a history of acute right-sided empyema. She was diagnosed with bacterial empyema and was treated. No tuberculosis (TB) examination was  \nperformed. She did not have any risk factors for TB, such as diabetes, chronic renal failure, oral steroid use or smoking. She had no history of exposure to TB or travel. CT revealed massive ascites and positron emission tomography-CT showed abnormal uptake in the pleura, peritoneum, systemic lymph nodes and bilateral ovaries (figure 1A,B). In addition, the CA125 level was as high as 421 U/mL, and the patient was referred for a detailed examination. Transvaginal ultrasonography showed no obvious abnormalities in the uterus or bilateral adnexa; however, massive ascites was noted (figure 2).  \nBlood tests showed a slight increase in CRP to 2.17 mg/dL and a slight decrease in the whited cell count to 2810x109/L. MRI showed thickening of the pelvic peritoneum and decreased diffusion in both ovaries (figure 3). Carcinomatous peritonitis secondary to ovarian cancer was suspected. On the fourth day after the initial visit, an examination laparoscopy was performed. Intraoperative findings","cbCaipeb5wYzjekg","https://ap.wps.com/l/cbCaipeb5wYzjekg","pdf",2012931,"English","# Summary\n# Background\n# Case presentation\n## Clinical presentation and imaging\n## Laparoscopic findings and surgical sampling\n## Pathology, microbiology, and test results\n# Key message","[{\"question\":\"Why was advanced ovarian cancer suspected in this case?\",\"answer\":\"Massive ascites, multiple peritoneal nodules, and abnormal uptake on PET-CT with elevated CA125 led to suspicion of advanced ovarian cancer.\"},{\"question\":\"What diagnostic evidence confirmed tuberculous peritonitis?\",\"answer\":\"Histopathological examination of tissue from the right fallopian tube showed epithelioid granulomas and Langhans giant cells, leading to a diagnosis of TB.\"},{\"question\":\"How could tuberculous peritonitis be mistaken for ovarian cancer?\",\"answer\":\"TB peritonitis can present with diffuse nodular lesions and ascites that resemble carcinomatous peritonitis, making preoperative differentiation difficult.\"}]","Tuberculous peritonitis diagnosed following laparoscopic examination for suspected advanced ovarian cancer | PDF",1789976090,13]