When Peritoneal Tuberculosis Mimics Carcinosis in a Patient Followed for Prostate Adenocarcinoma

Abstract

Peritoneal tuberculosis is a rare extrapulmonary manifestation of tuberculosis that often mimics peritoneal carcinomatosis clinically and radiologically, especially in patients with known malignancies. We present a case of a patient with prostate adenocarcinoma initially suspected to have peritoneal carcinomatosis due to radiological findings of peritoneal nodules and ascites. Exploratory laparoscopy revealed multiple small whitish nodules, and intraoperative frozen section examination showed necrotizing tuberculoid granulomatous inflammation consistent with tuberculosis. The patient was started on antituberculous therapy with careful adjustments to avoid interactions with his hormonal treatment. This case highlights the critical need for considering peritoneal tuberculosis in the differential diagnosis of peritoneal nodules to ensure timely and appropriate treatment and to avoid misdiagnosis and unnecessary interventions. Laparoscopic biopsy remains the gold standard for diagnosis in such challenging cases.