Extremely elevated CA-125 in benign ovarian disease due to stretch of the peritoneum

Vaid, Tejasvini; Schreuder, Henk W.R.

doi:10.1136/bcr-2012-006664

Cited by 8 publications

(6 citation statements)

References 22 publications

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“…In practice, if the preoperative CA125 level of a patient is less than 19 U/mL, the patient is more likely to have myoma than adenomyosis, indicating that different operation methods, including myomectomy, are possible in this case. Although the mechanism of increased CA125 is not fully established yet, the peritoneal irritation or peritoneal stretch associated with benign uterine conditions, such as myomas and adenomyosis, can modify levels of CA125 [8,23].…”

Section: Commentmentioning

confidence: 99%

Usefulness of CA125 in the differential diagnosis of uterine adenomyosis and myoma

Kil

Chung

Pak

et al. 2015

European Journal of Obstetrics & Gynecology and Reproductiv

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Section: Commentmentioning

confidence: 99%

Usefulness of CA125 in the differential diagnosis of uterine adenomyosis and myoma

Kil

Chung

Pak

et al. 2015

European Journal of Obstetrics & Gynecology and Reproductiv

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“…Serum concentrations of CA 125 are rarely elevated beyond 1000 U/mL in benign conditions of the ovary. 4 In this case CA 125 levels were extremely elevated to 3646 U/mL with imaging and macroscopic appearance mimicking malignancy. Staging laparotomy was planned with suspicion of malignancy.…”

Section: Discussionmentioning

confidence: 68%

Serous Papillary Cystadenofibroma of Ovary with Extremely Elevated CA 125—A Masquerader of Malignancy: A Case Report

Sivapragasam,

Nellore

2024

Journal of South Asian Federation of Obstetrics and Gynaecology

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Background: Benign serous papillary cystadenofibroma (SPCAF) of the ovary is a very rare subtype of serous tumors of the ovary. Commonly occurs between 15 and 65 years of age. They are usually asymptomatic or diagnosed as an incidental finding. Routine imaging features masquerade malignancy and lead to extensive surgeries. Intraoperative frozen section helps in avoiding radical surgeries. Case description: A 28-year-old multiparous, sterilized woman presented with complaints of lower abdominal pain, but no menstrual complaints. Abdominal examination revealed 14 × 14 cm solid with cystic lesion occupying lower abdomen. Ultrasound (US) and contrast enhanced computed tomography (CECT) of the abdomen showed a complex left ovarian cyst with torsion. CA 125 was extremely elevated 3646 U/mL. Other tumor markers were normal. A staging laparotomy was done. Intra-operative findings showed the left ovary replaced by 14 × 14 cm cyst, which underwent torsion 2 times. The ovarian cyst was untwisted and a left salpingo-oophorectomy was done. The cut section of the specimen showed papillary projections of 2 × 2 cm over the inner wall of the cyst. The frozen section histopathology report was benign SPCAF. Hence radical surgery was avoided. The final histopathology report revealed benign SPCAF of the left ovary. Conclusion: This case is presented in view of its rarity and atypical presentation. The presentation was atypical, since CA 125 was extremely elevated and imaging features suggested a malignant neoplasm. But intraoperative frozen section histopathology turned out to be a benign tumor thus avoiding radical surgery in a young patient. Clinical significance: Diagnosis of benign SPCAF ovary is difficult as imaging features masquerade malignancy, hence intraoperative frozen section plays a crucial role in definitive diagnosis and helps in avoiding extensive surgeries.

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“…The elevated serum CA-125 in our patient might be a consequence of peritoneal stretching. The giant hydronephrosis could have stretched the peritoneum of the whole abdominal cavity and stimulated mesothelial cell linings to produce CA-125 17 . There have been several previous reports of hydronephrosis with increased CA-125 4 , 18 , 19 .…”

Section: Discussionmentioning

confidence: 99%

Giant hydronephrosis masquerading as ovarian tumor: a case report

Kurniadi

Kurniaputra²,

Yulianti³

et al. 2023

Annals of Medicine &Amp; Surgery

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Introduction and importance: Giant hydronephrosis is defined as the accumulation of more than 1 l of fluid in the kidney’s collecting system. Its presentation can mimic other conditions including ovarian tumor. Herein, the authors report a case of giant hydronephrosis caused by urolithiasis that mimics the presentation of an ovarian tumor. The authors also highlight the challenges in diagnosing this rare entity and the management options available. Case presentation: The authors present a case of a 65-year-old P5A0 woman with an abdominal tumor of 1-year duration that progressively increased in size. She also complained of mild left flank pain since a year ago. Ultrasonography revealed a large cystic mass in the lower to middle abdomen. Ovarian tumor was suspected and laparotomy was performed. Surgical exploration revealed a left giant hydronephrosis with normal gynecological organs. The postoperative course was uneventful, and she was discharged in satisfactory condition. Clinical discussion: Giant hydronephrosis should always be considered as a differential diagnosis when presented with a large abdominal cystic lesion. Conclusion: Routine screening for bilateral kidneys during gynecological ultrasonography will help detect giant hydronephrosis and prevent unplanned surgical interventions.

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Extremely elevated CA-125 in benign ovarian disease due to stretch of the peritoneum

Cited by 8 publications

References 22 publications

Usefulness of CA125 in the differential diagnosis of uterine adenomyosis and myoma

Usefulness of CA125 in the differential diagnosis of uterine adenomyosis and myoma

Serous Papillary Cystadenofibroma of Ovary with Extremely Elevated CA 125—A Masquerader of Malignancy: A Case Report

Giant hydronephrosis masquerading as ovarian tumor: a case report

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