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Obstetrics & Gynecology 2004;104:1177-1179
© 2004 by The American College of Obstetricians and Gynecologists
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CASE REPORTS

Coccidioidomycosis Mimicking Ovarian Cancer

Michael W. Ellis, MAJ, MC, USA*, David P. Dooley, COL, MC, USA*, Michael J. Sundborg, LTC, MC, USA{dagger}, Laura L. Joiner, CPT, MC, USA{dagger} and Edward R. Kost, LTC, MC, USA{dagger}

Departments of *Medicine and {dagger}Obstetrics and Gynecology, Brooke Army Medical Center, Fort Sam Houston, Texas

Address reprint requests to: Michael West Ellis, MD, MAJ, MC, Infectious Disease Service MCHE-MDI, Brooke Army Medical Center, 3851 Roger Brooke Drive, Fort Sam Houston, TX; e-mail: Michael.Ellis2{at}cen.amedd.army.mil.

BACKGROUND: Dissemination of coccidioidomycosis to the abdominal cavity is rare. No previous case of peritoneal coccidioidomycosis has presented as an adnexal mass.

CASE: We report a case of peritoneal coccidioidomycosis mimicking ovarian carcinoma. The patient presented with a complex ovarian mass, ascites, omental caking, and an elevated CA 125. The ultimate diagnosis was not made until frozen section histopathology was performed at staging laparotomy.

CONCLUSION: Peritoneal coccidioidomycosis can present with the clinical, radiographic, and serologic features of ovarian cancer. Although essential for diagnosis and staging, radiographic studies and tumor markers have limited specificity. Coccidioidomycosis now joins other benign conditions that comprise the differential diagnosis of patients who present with what seems to be advanced ovarian carcinoma. Infectious diseases consultation is recommended for the management of peritoneal coccidioidomycosis.






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