Peritoneal Tuberculosis with Elevated Ca 125 Levels,
a Diagnostic Challenge and Value of Laparoscopy and
Ada Level in the Differential Diagnosis

M. Ziya GÜNENÇ, Banu BİNGÖL, Selçuk TABAK, Batu AYDİNURAZ
Ankara-Turkey

In this report, a peritoneal tuberculosis with ascites and elevated Ca 125 levels is evaluted. The patient was initially thought to have an ovarian cancer. Studies for differential diagnosis before the operation included measurement of Ca 125 levels , ADA (Adenosine Deaminase) and microbiological and cytologic examination of the ascitic fluid, ultrasonography and computerized tomography of the abdomen, and laparascopy with biopsy. The characteristic appearance of peritoneum and abdominal organs, histologic diagnosis of biopsies, serum Ca 125, ADA levels of ascidic fluid results were highly suggestive for tuberculous peritonitis. Quadraple antituberculous chemotherapy was began and Ca 125 levels dropped from 437 U/ml to 14 U/ml after two months of the therapy.
(Gynecol Obstet Reprod Med 2005; 11:215-217)

Key Words: Tuberculous peritonitis, Ca 125, Laparoscopy,ADA, Differential Diagnosis