Abstract
Peritoneal tuberculosis (TB) is a rare extrapulmonary manifestation that can closely mimic peritoneal carcinomatosis or pseudomyxoma peritonei (PMP) due to overlapping imaging features such as omental caking, ascites, and adnexal masses. We present a case of a young woman in her early 20s with peritoneal TB with scalloped liver margins and peritoneal thickening with bulky ovaries, initially suspected as PMP. Imaging and laboratory findings led to suspicion of malignancy, but cartridge-based nucleic acid amplification test (CBNAAT) analysis confirmed TB. This case underscores the importance of recognizing imaging clues that might help to distinguish TB from peritoneal neoplasms.