Pelvic tuberculosis presenting with pyometra in a post-menopausal woman

63 yaşında, postmenopozal kadın hasta vajinal akıntı, karın ağrısı ve ateş şikayetiyle jinekoloji polikliniğine başvurdu. Ultrasonografide pyometri tespit edildi. Serum CA-125 ve CA 19-9 düzeyleri yüksekti. Endometrial biyopside malignite ve aside dirençli basil saptanmadı. Bilateral salpingo-ooferektomi ve total histerektomi yapıldı. Histolojik incelemede kazeöz granülomatöz inflamasyon saptandı. Genital tüberküloz tanısı koyuldu ve antitüberküloz tedavi başlandı. Burada, postmenopozal bir hastada yüksek CA 125 ile CA 19 9 seviyeleri ve pyometri ile prezente olan pelvik tüberküloz vakası sunulmaktadır.

Post menopozal bir kadında pyometra ile presente olan pelvik tüberküloz

A 63-years-old postmenopausal woman was admitted to the gynecology clinic with vaginal discharge, abdominal pain, and pyrexia. Ultrasonography revealed evidence of pyometra. Serum CA-125 and CA 19-9 levels were elevated. Endometrial biopsy revealed no malignant cells or acid-fast bacilli. We performed total hysterectomy with bilateral salpingo-oophorectomy. Histological examination revealed caseous granulomatous inflammation. The diagnosis of genital tuberculosis was made and antituberculosis treatment was initiated. Here, we present a pelvic tuberculosis with pyometra in a post-menopausal women with elevated CA 125 and CA 19 9 levels.

___

  • 1. Chan LY, Lau TK, Wong SF, Yuen PM. Pyometra. What is its clinical significance? J Reprod Med 2001;46(11):952-6.
  • 2. Carter JR. Unusual presentations of genital tract tuberculosis. Int J Gynaecol Obstet 1990;33(2):171-6.
  • 3. Chow TW, Lim BK, Vallipuram S. The masquerades of female pelvic tuberculosis: Case reports and review of literature on clinical presentations and diagnosis. J Obstet Gynaecol Res 2002;28(4):203-10.
  • 4. Bilgin T, Karabay A, Dolar E, Develioglu OH. Peritoneal tuberculosis with pelvic abdominal mass, ascites and elevated CA125 mimicking advanced ovarian carcinoma: A series of 10 cases. Int J Gynecol Cancer 2001;11(4):290-4.
  • 5. World Health Organisation, Treatment of Tuberculosis. Guidelines for National Programmes. Geneva; 1997.
  • 6. Sharma SK, Mohan A. Extrapulmonary tuberculosis. Indian J Med Res 2004;120(4):316-53.
  • 7. Çetin MT, Demir CS, Kadayıfçı O, Kurdoğlu N. Neglected disease; genital tuberculosis. J Turkish German Gynecol Assoc 2006;7(2):94-97.
  • 8. Saracoglu OF, Mungan T, Tanzer F. Pelvic tuberculosis. Int J Gynaecol Obstet 1992;37(2):115-20.
  • 9. Straughn JM, Robertson MW, Partridge EE. A patient presenting with a pelvic mass, elevated C a-125 and fever. Gynecol Oncol 2000;77(3): 471-2.
  • 10. Tascı C, Ozkaya S, Ozkara B, et al. The utility of tumor markers CA 125, CA 15-3, and CA 19-9 in assessing the response to therapy in pulmonary and pleural tuberculosis. Onco Targets Ther 2012;5(4):385-90.
  • 11. Pavai S, Yap SF. The clinical significance of elevated levels of serum CA 19-9. Med J Malaysia 2003;58(5):667-72.
  • 12. Takayama S, Kataoka N, Usui Y, et al. CA 19-9 in patients with benign pulmonary diseases. Nihoh Kyobu Shikkan Gakki Zasshi 1990;28(10):1326-31.