Pediatric Gastroenterology, Hepatology & Nutrition

The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition (대한소아소화기영양학회)
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A Case of Abdominal Tuberclosis Mimicking Ovarian Cancer

난소 종양의 임상적 양상을 보인 소아 복막 결핵

  • Yeom, Jung Sook (Department of Pediatrics, Gyeongsang National University College of Medicine) ;
  • Kim, Jae Hui (Department of Pediatrics, Gyeongsang National University College of Medicine) ;
  • Cho, Jae Min (Department of Radiology, Gyeongsang National University College of Medicine) ;
  • Lee, Jeong Hee (Department of Pathology, Gyeongsang National University College of Medicine) ;
  • Park, Eun Sil (Department of Pediatrics, Gyeongsang National University College of Medicine) ;
  • Seo, Ji Hyun (Department of Pediatrics, Gyeongsang National University College of Medicine) ;
  • Lim, Jae Young (Department of Pediatrics, Gyeongsang National University College of Medicine) ;
  • Park, Chan Hoo (Department of Pediatrics, Gyeongsang National University College of Medicine) ;
  • Woo, Hyang Ok (Department of Pediatrics, Gyeongsang National University College of Medicine) ;
  • Youn, Hee Shang (Department of Pediatrics, Gyeongsang National University College of Medicine)
  • 염정숙 (경상대학교 의과대학 소아과학교실) ;
  • 김재희 (경상대학교 의과대학 소아과학교실) ;
  • 조재민 (경상대학교 의과대학 진단방사선학교실) ;
  • 이정희 (경상대학교 의과대학 해부병리학교실) ;
  • 박은실 (경상대학교 의과대학 소아과학교실) ;
  • 서지현 (경상대학교 의과대학 소아과학교실) ;
  • 임재영 (경상대학교 의과대학 소아과학교실) ;
  • 박찬후 (경상대학교 의과대학 소아과학교실) ;
  • 우향옥 (경상대학교 의과대학 소아과학교실) ;
  • 윤희상 (경상대학교 의과대학 소아과학교실)
  • Received : 2005.07.25
  • Accepted : 2005.08.20
  • Published : 2005.09.01
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Abstract

We report the case of a girl with peritoneal tuberculosis (Tb) who presented with mimicking features of ovarian cancer including massive ascites, elevation of CA-125 and ovarian masses. These ovarian masses cannot be ruled out malingnacy with image study. Gram stain, acid-fast stain, bacteriological and mycological culture of centrifuged ascites cells were negative. Tumor markers revealed an elevated CA-125 level of 112 U/mL and adenosine deaminase level were significantly high with 118 U/L. Diagnostic laparoscopy was done. The histology of the peritoneum and the ovary showed multiple granulomatous nodules with epithelioid cells and multi-nucleated giant cells. And there were no evidence of malignancy. Furthermore acid-fast bacilli (AFB) was identified in this specimen. Peritoneal Tb was difficult to diagnosis in our patient because it mimicked ovarian cancer. And this is the first case of abdominal Tb mimicking ovarian cancer in children in Korea.

복부 팽만과 복수, 복부 종괴 및 혈청 CA-125가 상승하는 경우 반드시 복막 결핵을 의심해야 하며 보다 정확하고 빠른 진단을 위해 복막 천자를 통한 염색 및 균 배양뿐 아니라 ADA, 중합 효소 연쇄 반응 및 진단적 복강경 검사 등이 필요하다. 저자들은 난소 종양의 임상 양상을 보인 5세 여아에서 복막 결핵을 진단한 예가 있어 문헌 고찰과 함께 보고하는 바이다.

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