J Gastric Cancer.  2016 Jun;16(2):111-114. 10.5230/jgc.2016.16.2.111.

Gastric Cancer with Peritoneal Tuberculosis: Challenges in Diagnosis and Treatment

• Alshahrani AS
• Lee IS

• KMID: 2328078
• DOI: http://doi.org/10.5230/jgc.2016.16.2.111

Abstract

Herein, we report a 39-year-old female patient presenting with gastric cancer and tuberculous peritonitis. The differential diagnosis between advanced gastric cancer with peritoneal carcinomatosis and early gastric cancer with peritoneal tuberculosis (TB), and the treatment of these two diseases, were challenging in this case. Physicians should have a high index of suspicion for peritoneal TB if the patient has a history of this disease, especially in areas with a high incidence of TB, such as South Korea. An early diagnosis is critical for patient management and prognosis. A surgical approach including tissue biopsy or laparoscopic exploration is recommended to confirm the diagnosis.

Keyword

Stomach neoplasms; Tuberculous peritonitis; Peritoneal carcinomatosis

MeSH Terms

Adult
Biopsy
Carcinoma
Diagnosis*
Diagnosis, Differential
Early Diagnosis
Female
Humans
Incidence
Korea
Peritonitis, Tuberculous*
Prognosis
Stomach Neoplasms*

Figure

• 

  Fig. 1 (A) Gastroscopy showing a 2-cm antral ulcerative lesion. (B) Chest computed tomography showing left pleural effusion, sub-aortic and right para-tracheal lymph node enlargement, and plural nodularity.

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  Fig. 2 (A, B) Initial abdomen computed tomography (CT). (A) Mesenteric haziness. (B) Pelvic ascites. (C, D) Follow-up abdomen CT scan. (C) Minimally improved mesenteric haziness. (D) Minimally reduced pelvic ascites.

• 

  Fig. 3 Intraoperative view. The visceral and parietal peritoneum shows the presence of multiple whitish nodules, with 'violin-string' fibrinous strands.

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