Elevated serum CA 125 and adnexal mass mimicking ovarian carcinoma in a patient with tuberculous peritonitis.

A 49 year old woman presented with weight loss, diffuse abdominal pain and distension, low grade fever, massive ascites, and an increased serum CA 125 value. Computed tomography of the abdomen and pelvis and ultrasonography of the pelvis were suggestive of ovarian carcinoma. Exploratory laparotomy revealed massive ascites; diffuse peritoneal studding of numerous 1- to 2-mm implants in the bowel, omentum and abdominal wall; a cystic adnexal mass; and indurated head of the pancreas. Histopathological examination of several implants showed multiple epitheloid granulomata with rare central necrosis. The patient responded well to antituberculous therapy.