Elevated CA 125 level in a mucinous cystadenoma and a teratoma: a case report (original) (raw)
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Gynecology Obstetrics & Reproductive Medicine, 2016
OBJECTIVE: We aimed to determine the diagnostic values of some clinical and ultrasonographic features for predicting ovarian malignancies in patients with normal serum CA-125 levels. STUDY DESIGN: All of the 84 patients who were diagnosed with ovarian malignancy and 168 patients with benign adnexal mass had normal CA-125 levels, and recruited as study and control groups, respectively. Individual characteristics, ultrasonographic features, and risk of malignancy index (RMI) values of the groups were compared retrospectively. RESULTS: The ages, mean postmenopausal period of the postmenopausal women in the malignant group were significantly higher than the benign group. Nulliparity rates were similar between the two groups. The number of postmenopausal patients was significantly higher in the malignant group. Median cyst diameter and RMI values were significantly higher, and bilaterality and presence of solid area were more frequent in this group. Logistic regression model showed that ovarian cysts larger than 8 cm [Odds ratio (OR): 7.012; p<0.001; 95% Confidence interval (CI): 3.463-14.198], presence of solid area within the cyst [OR: 7.43; p<0.001; 95% CI: 3.799-14.532], and postmenopausal state [OR: 2.893; p=0.027; 95% CI: 1.129-7.412] were found to be significant factors to predict malignancy. CONCLUSIONS: Ovarian cysts larger than 8 cm, presence of solid area within the cyst, and postmenopausal status are the most important risk factors for ovarian malignancies in these patients with normal CA-125 levels.
Tumor markers in mature cystic teratomas of the ovary
Archives of Gynecology and Obstetrics, 2008
Objective The objective of this study was to evaluate the serum levels of tumor markers in patients with ovarian mature cystic teratomas. Method Retrospective study of 215 patients operated at Zekai Tahir Burak Women Health Education and Research Hospital between January 2001 and October 2006 was performed. Results The median age was 36 years (range 13-80). The mean tumor diameter was 7.7 § 4.6 cm (range 2-25). The mean serum CA 125 level was 26.2 § 29.9 U/mL (range 1.4-225, normal value <35), and the mean serum CA 19-9 level was 83.5 § 179.2 IU/mL (range 0.6-1,000; normal value <37). The elevated rate of CA 19-9, CA 125 was 39.6% (74/187) and 23.3% (50/215), respectively. The mean age of patients and the rate of bilaterality of tumors were similar in both patients with elevated CA19-9 and with normal CA 19-9 level (P > 0.05). The mean tumor size of patients with elevated CA 19-9 was greater than those with normal CA19-9 level (P = 0.01). Conclusion Serum CA 19-9 has the highest positivity rate among other tumor markers in ovarian mature cystic teratomas. Elevated serum CA 19-9 levels are correlated with larger tumor size. But the diagnostic value of elevated CA 19-9 in patients with MCT would be poor if the test was used alone.
Tubo-ovarian abscesses with elevated CA-125: A case report
International Journal of Case Reports and Images, 2016
Introduction: The detection of pelvic masses with an elevated blood cancer antigen 125 (CA-125) level is highly suggestive of ovarian cancer. However, various benign and inflammatory gynecological conditions and non-gynecological processes, such as liver and pulmonary diseases, may be associated with an elevated serum CA-125 level, especially in premenopausal women. Case Report: An 18-year-old female patient with lower abdominal pain for three days presented to our hospital. No fever was noted. Blood cancer antigen 125 (CA-125) level was elevated (660 U/mL; normal value, <35 U/mL), while the levels of other tumor markers (α-fetoprotein, carcinoembryonic antigen, β-human chorionic gonadotropin, and CA-199) were within normal limits. Transabdominal ultrasonography showed multicystic lesions with interior septation in the adnexal regions on both sides, suggesting the presence of cystic masses in both ovaries. Contrast-enhanced magnetic resonance imaging (MRI) revealed dilated and tu...
May increased CA125 in borderline ovarian tumor be indicative of a poor prognosis? A case report
Tumor Biology, 2014
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Differential diagnosis of benign ovarian cysts using tumor markers in serum and cyst fluid
Little Bay Publishers, 2021
D ifferentiating the type of benign ovarian cyst can result in better care. Aims: To measure CA-125, CA 19-9, Carcinoembryonic Antigen (CEA), and Alpha-fetoprotein (AFP) in serum and cyst fluid of patients with benign ovarian cysts and whether these biomarkers can be used to identify the type of the cyst. Methods and materials: Patients with benign ovarian cysts undergoing laparoscopic cystectomy were included. Cyst types were determined histologically. Levels of CA 125, CA 19-9, CEA and AFP were measured in serum and cyst fluid. Results: 98 cysts (25 functional, 12 endometrioma, 15 dermoid, 28 mucinsous cystadenoma, 18 serous cystadenoma) were evaluated. There was a significant difference in levels of CA 125 and CA 19-9 in serum and CA-125, CA 19-9, and CEA in cyst fluid. For diagnostic purposes, a ≥35 IU/mL value for serum CA 125 predicted endometriomas with a sensitivity of 91.7% and a specificity of 91.9%. A value of ≤22.5 IU/mL for cyst fluid CA 19-9 predicted functional cysts with a sensitivity of 92% and specificity of 95.2%. A ≥100 ng/mL value for cyst fluid CEA predicted mucinous cysts with a sensitivity of 96.4% and a specificity of 96.7%. Conclusion: Levels of CA-125, CA 19-9, and CEA in serum and cyst fluid of patients with benign ovarian cysts can be used as a diagnostic tool for inpatient evaluation with acceptable sensitivity and specificity. This finding can be used in conjunction with other methods such as ultrasound, especially in cases that are harder to diagnose.
Journal of Kathmandu Medical College, 2018
Introduction: Mature cystic teratoma of ovary, categorized as germ cell tumor is commonly seen in females of reproductive age group. The main aim of this study is to evaluate the serum level of CA 19-9 in those patients.Methods: A prospective study on 65 patients at First Affiliated Hospital, Guangxi Medical University, China within the period of one year. Patients underwent pelvic examination, ultra-sonograph and evaluation of serum level of CA 19-9, CA 125, CEA, AFP and SCCA prior to surgery. Following the surgery, samples were subjected for histo-pathological analysis where confirmatory diagnosis of Mature Cystic teratoma of ovary was established. Serum CA 19-9 was then re-analyzed following surgical removal of the tumor.Results: Mean age of patients with mature Cystic teratoma was 32.5±12.1 years (range 15-71). Mean tumor diameter was 5.8±2.4cm (range 2.3-12.2). Serum level of CA19-9 was the only tumor marker with a mean serum level (49.9±73.4IU/ml) above the cut-off value and i...
Tubo-Ovarian Mass with raised CA-125 in 21-year-old female
Research Square (Research Square), 2022
Introduction: Peritonitis associated with fungal species Curvularia lunata seldom occurs with only ve cases reported in literature, all in middle age patients with comorbidities undergoing dialysis. Case Report: A 21-year-old female who was referred to surgical oncology OPD with a diagnosis of ovarian malignancy, based on raised cancer antigen 125 (CA 125) and suspected tubo-ovarian mass (TOM) on MRI. Review of the MRI showed pelvic collection with TOM, suggestive of infective pathology. Ultrasound guided aspiration of the cystic collection identi ed the presence of Curvularia lunata. She was treated with oral Itraconazole which showed symptomatic improvement and radiological response. In the followup period the patient developed chest wall swelling, aspiration and geneXpert® revealed MDR tuberculosis and treatment was started. Conclusions: Unusual causes of TOM and raised CA 125 should be kept in mind when dealing with young patients, as the possibility of epithelial ovarian cancer in this age is very low.