Isolated Ovarian Tuberculosis Mimicking Ovarian Malignancy in a Young Female with Primary Infertility: A Case Report.

BackgroundTuberculosis (TB) is an infectious disease that most commonly affects the lungs and remains among the top 10 causes of death worldwide. Isolated ovarian tuberculosis is a rare form of extrapulmonary TB that usually presents with atypical symptoms and infertility. It brings significant diagnostic challenges and may mimic ovarian malignancy.Case presentationA 23-year-old nulliparous Afghan woman underwent laparotomy for suspected ovarian adnexal masses/ovarian tumor after presenting with pelvic pain, prolonged low-grade fever, and infertility for five years following marriage. Intraoperatively, bilateral ovarian cysts were noted; subsequently, bilateral cystectomies were done. Postoperative Histopathology of surgical specimens confirmed the diagnosis of tuberculosis lesions, and the patient was referred for anti-tuberculous therapy.ConclusionIsolated ovarian tuberculosis can present as adnexal masses with elevated CA-125 and could closely mimic ovarian malignancy. This case highlights the need to consider ovarian tuberculosis in the differential diagnosis, particularly in endemic regions. It emphasizes the value of histopathological confirmation to prevent misdiagnosis and to recommend early initiation of antitubercular therapy for favorable clinical outcomes.