Objective: Tuberculosis infection of the female genital organs most commonly presents with infertility, menstrual irregularities, dyspareunia and chronic PID. Very infrequently, the disease may mimic an ovarian malignancy and pre-operative differentiation between the two becomes a real challenge.

Patients and Methods: A study of all cases of female genital tuberculosis diagnosed in the last two years and presenting with features of ovarian neoplasm in a tertiary level institute was done.

Results: Out of 28 patients, eight women of GTB had atypical presentation and had a different primary diagnosis. Out of these, two women presented with acute abdomen and a primary diagnosis of tubal pregnancy was made in one and pyosalpinx in other. Six women presented with tubo-ovarian masses and elevated CA-125 levels. A primary diagnosis of tubo-ovarian malignancies was made in all these cases and laparotomy was done in each. The final diagnosis of genital tuberculosis was confirmed through the histopathological examination in each of these six patients and the patients responded on antitubercular treatment.

Conclusions: A high index of suspicion is required for diagnosis of cases of tuberculosis, especially in endemic areas. Though mainstay of treatment is anti-tubercular therapy, however adequate surgical intervention in advanced cases can expedite the recovery of patient.