The difficulty of making a differential diagnosis in a young female patient with ascites: a case report

Abstract

There is a difficulty in differential diagnosis between peritoneal tuberculosis and malignant ovarian neoplasm due to the similarity of clinical picture, laboratory and instrumental examination data. In this article, we describe a clinical case of a young patient with ascites and gastrointestinal symptoms. The examination revealed ovarian masses and signs of peritoneal carcinomatosis, as well as lung nodules. However, the clinical presentation was atypical for ovarian cancer, and lung lesions were suspicious for tuberculous, which allowed to hypothesize regarging tuberculosis of multiple localizations. The diagnosis was confirmed by laparoscopy with biopsy of the involved tissues and subsequent histologic and laboratory confirmation of the etiologic role of Mycobacterium tuberculosis. The described case demonstrates the importance of using all available diagnostic methods in establishing the causes of ascites in young female patients for differential diagnosis between specific and neoplastic etiologies.