Endometrioma mimicking ovarian cancer with unusual high levels of serum CA 125 and Ca 19-9

Year 2013, Volume: 2 Issue: 4, 170 - 173, 26.03.2014

Nuri Peker , Ahmet Demir Özgür Bige

Abstract

Abstract

A 35 year-old nulliparous woman was referred to our clinic with left ovarian mass (6x7 cm in size) accompanied by excessive free fluid at pouch of Douglas and elevated levels of serum CA 125 and CA 19-9 as 1061 IU/mL and 896 IU/mL, respectively. Laparotomy was performed with the suspect of ovarian cancer. Left ovarian endometrioma adherent to the sigmoid colon was observed and enuclated. Histopathological examination confirmed the diagnosis of endometrioma. Adnexal mass with free peritoneal fluid and high levels of tumor antigens; CA 125 and CA 19-9 mimicking ovarian cancer has been rarely diagnosed as endometrioma.

Keywords: CA 125, CA 19-9, endometriosis

Özet

Otuz beş yaşında, nullipar bir kadın adneksial kitle nedeni ile kliniğimize sevk edildi. Douglas boşluğunda belirgin sıvı birikimi ve yüksek CA 125 (1061 IU/mL) ve CA 19-9 (896 IU/mL) seviyeleri ile birlikte 6x7 cm boyutlarında sol over kitlesi vardı. Over kanseri ön tanısı ile laparotomi yapıldı. Sol yumurtalıkta sigmoid kolona yapışık endometrioma bulundu ve çıkartıldı. Histopatolojik inceleme endometrioma tanısını doğruladı. Asit ve yüksek CA 125 ve CA 19-9 düzeyleri ile birlikte olan yumurtalık kanserini taklit eden endometrioma nadir saptanan bir durumdur.

Anahtar sözcükler: CA 125, CA 19-9, endometrioma

Keywords

CA 125, CA 19-9, endometriosis

References

• References
• Yilmazer M, Sonmezer M, Gungor M. Unusually elevated serum carbohydrate antigen 125 (CA125) and CA19-9 levels as a result of unruptured bilateral endometrioma. Aust N Z J Obstet Gynaecol. 2003 Aug;43(4):329-30.
• Kurata H, Sasaki M, Kase H, Yamamoto Y, Aoki Y, Tanaka K. Elevated serum CA125 and CA19-9 due to the spontaneous rupture of ovarian endometrioma. Eur J Obstet Gynecol Reprod Biol. 2002 Oct 10;105(1):75-6.
• Harada T, Kubota T, Aso T. Usefulness of CA19-9 versus CA125 for the diagnosis of endometriosis.Fertil Steril. 2002 Oct;78(4):733-9.
• Mabrouk M, Elmakky A, Caramelli E, Farina A, Mignemi G, Venturoli S, Villa G,Guerrini M, Manuzzi L, Montanari G, De Sanctis P, Valvassori L, Zucchini C, Seracchioli R. Performance of peripheral (serum and molecular) blood markers for diagnosis of endometriosis. Arch Gynecol Obstet. 2012 May;285(5):1307-12.
• Kurdoglu Z, Gursoy R, Kurdoglu M, Erdem M, Erdem O, Erdem A. Comparison of the clinical value of CA 19-9 versus CA 125 for the diagnosis ofendometriosis. Fertil Steril. 2009 Nov;92(5):1761-3. doi: 10.1016/j.fertnstert.2009.05.022. Epub 2009 Jul 23.
• Johansson J, Santala M, Kauppila A. Explosive rise of serum CA 125 following the rupture of ovarian endometrioma. Hum Reprod. 1998 Dec;13(12):3503-4.
• Takemori M, Sugimura K. Ovarian chocolate cyst with markedly elevated serum CA19-9 level: a case report. Eur J Obstet Gynecol Reprod Biol. 1991 Dec 13;42(3):241-4.
• Park BJ, Kim TE, Kim YW. Massive peritoneal fluid and markedly elevated serum CA125 and CA19-9 levels associated with an ovarian endometrioma. J Obstet Gynaecol Res. 2009 Oct;35(5):935-9.