Peritoneal tuberculosis in the differential diagnosis with peritoneal carcinomatosis: case report and literature review

Tuberculosis is a severe public health problem in developing countries, but it is taking on the characteristics of a global epidemic. By virtue of migration flows, in fact, we are observing a resurgence of this disease in western countries, in all its forms including the genital one. The problem became more serious with the emergence of multidrug-resistant mutant (MDR) strains of Mycobacterium Tuberculosis. In this paper we describe a case of peritoneal tuberculosis, whose diagnosis was histologically made after laparoscopic examination. Laparoscopy proved crucial for the differential diagnosis with peritoneal carcinomatosis, particularly following the discrepancy in the results provided by ultrasound and Computerized Tomography (CT) examinations. These two diseases are, in fact, very different in their pathogenesis, but above all in their treatment options and prognostic outcomes. Genital tuberculosis is a major cause of severe tubal disease leading to infertility. Unlike pulmonary tuberculosis, its clinical diagnosis is difficult because in most of cases genital tuberculosis can be asymptomatic or have a large variety of clinical features. \ua9 Copyright 2012, CIC Edizioni Internazionali, Rome