Background: Tuberculosis (TB) is endemic in the Indian subcontinent and there is an increasing trend of peritoneal TB, which has been noted in recent years. Elevation of CA-125 in peritoneal TB has been reported and misinterpreted as disseminated ovarian malignancy. Case: A 19-year-old female adolescent presented with abdominal distention and pain in her abdomen. Ultrasound and computed tomography scanning revealed the presence of ascites, omental thickening, and bilateral enlarged ovaries. A laboratory test showed that she had elevated serum CA-125. This patient was misdiagnosed as having ovarian malignancy and underwent a laprotomy. Results: Once this patient was diagnosed correctly following histologic testing, treatment with antitubercular drugs produced a resolution of symptoms with a reduction in her CA-125 level to baseline. Conclusions: Tuberculous peritonitis should be considered in the differential diagnosis of patients with ascites and elevated serum CA-125. This marker may be useful for monitoring treatment response. (J GYNECOL SURG 30:377)
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