Peritoneal tuberculosis impersonating ovarian malignancy: A case series from a high tuberculosis burden country

An uncommon form of extrapulmonary tuberculosis is abdominal tuberculosis (TB). Due to its vague symptoms, abdominal TB remains difficult to diagnose. We report three cases of peritoneal TB with abdominal enlargement in Bandung, Indonesia, which were initially misdiagnosed as ovarian carcinoma and treated with biopsy and laparotomy. To avoid unnecessary invasive procedures that pose risks to patients, we assess the need for a diagnostic strategy to differentiate between ovarian cancer and abdominal TB based on our experiences and existing literature. Peritoneal TB closely mimics ovarian cancer in clinical presentation, imaging findings, and tumor marker profiles. Elevated CA-125 and ascitic fluid analysis may mislead clinicians, especially in resource-limited settings. To prevent misdiagnosis, careful diagnostic procedures should be undertaken.