rss
BMJ Case Reports 2012; doi:10.1136/bcr-2012-006664
  • Unusual presentation of more common disease/injury

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

  1. Henk W R Schreuder1
  1. 1Division of Women and Baby, Department of Reproductive Medicine and Gynaecology, University Medical Centre Utrecht, Utrecht, Netherlands
  2. 2Department of Obstetrics and Gynaecology, Kasturba Hospital, Kasturba Medical College, Manipal, India
  1. Correspondence to Dr Henk W R Schreuder, h.w.r.schreuder{at}umcutrecht.nl

Summary

Serum concentrations of CA-125 are rarely elevated beyond 1000 U/ml in benign conditions of the ovary in postmenopausal women. In this report, the authors present an unusual case of a 78-year-old woman with an extremely elevated CA-125 concentration of 2897 U/ml without the presence of a malignancy, ascites or pleural effusion. Imaging revealed a large intra-abdominal cystic mass with irregular solid deviations on CT scan, most likely arising from an ovary. Exploratory laparotomy was performed with suspicion of ovarian cancer but histopathological analysis revealed benign serous cystic adenofibroma. This case report highlights the diagnostic challenge of extremely increased levels of CA-125 in postmenopausal women. A possible explanation for this CA-125 elevation could be the mechanical stretch of the peritoneum.

Register for free content

The full text of all Editor's Choice articles and summaries of every article are free without registration

The full text of Images in ... articles are free to registered users

Only fellows can access the full text of case reports (apart from Editor's Choice) - become a fellow today, or encourage your institution to, so that together we can grow and develop this resource

Don't forget to sign up for content alerts so you keep up to date with all the case reports as they are published, and let us know what you think by commenting on the Editor's blog

Navigate This Article