Is Tuberculosis Still a Threat in the Developed World? Two Cases of Tuberculosis Masquerading as Gynecologic Cancers

Abstract

Jennifer WH Wong, Tiffany S Lai, Kimberly KM Nagamine, Jeffrey L Killeen and Michael E Carney

Summary: Two cases of Filipina women with tuberculosis mimicking gynecologic cancers remind physicians to include tuberculosis in the differential diagnosis, especially for patients from endemic areas. Background: Tuberculosis is difficult to diagnosis and can mimic gynecologic cancers. Distinguishing these diseases is important in patient management.

Case 1: A 55-year-old female Filipina immigrant presented with pelvic pain. She had an elevated CA-125, ascites, abdomino-pelvic nodules, and pulmonary nodules. She underwent surgery for suspected metastatic ovarian cancer and was diagnosed with tuberculosis.

Case 2: A 75-year-old female Filipina immigrant presented with gastric burning. She had pyometra, a 0.5x1.0cm cervical mass, and 4.4cm endometrial mass. She underwent surgery for suspected uterine cancer and was diagnosed with tuberculosis.

Conclusion: A high index of suspicion is key to pre-operatively diagnose tuberculosis because its clinical picture overlaps greatly with that of gynecologic cancers in high risk populations. If tuberculosis is suspected, a screening test should be performed

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