Background: Mycobacterium tuberculosis affects about 30% of world’s population and infection occurs at a rate of one per second. In 2010, tuberculosis accounted for 8.8 million new cases, was responsible for 1.45 million deaths with majority of cases in developing countries. Tuberculosis is the most common cause of mortality in women of reproductive age. Peritoneal tuberculosis accounts for 4% of all extrapulmonary diseases and often mimics ovarian malignancy due to its nonspecific symptoms. Case: A 25-year-old woman with ovarian mass and an elevated cancer antigen 125 (CA-125) underwent an exploratory laparotomy to search for ovarian tumor. The final pathological diagnosis was miliary abdominal tuberculosis. Discussion: Peritoneal tuberculosis often mimics ovarian malignancy due to its nonspecific symptoms and is a major health problem in developing countries. There is no particular diagnostic test to differentiate this disease from advanced ovarian carcinoma, making it difficult to avoid extensive surgery. Laparoscopy is the diagnostic modality of choice.
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