title: Torsion of an ovarian borderline tumor with extreme serum tumor markers: a case report.
abstract: A postmenopausal woman with torsion of the left ovarian mucinous cystadenoma with borderline malignancy is reported. Extremely elevated serum tumor markers such as carcinoembryonic antigen (CEA) (398.0 ng/mL, normal < 3.0 ng/mL), carbohydrate antigen 19-9 (CA 19-9) (240 U/mL, normal < 37 U/mL) and tissue polypeptide antigen (TPA) (1,918 U/L, normal < 110 U/L) were found preoperatively. Imaging studies such as ultrasound and computed tomogram favored a diagnosis of ovarian malignancy, and advanced ovarian cancer was suspected prior to operation. Diagnosis of borderline malignancy was first made by frozen section during laparotomy. The patient recovered following simple total hysterectomy and bilateral salpingo-oophorectomy. Serum levels of the tumor markers became normal gradually following operation. To present knowledge, this is the first reported case with extremely high serum tumor markers in a postmenopausal woman with torsion of a stage-Ia ovarian mucinous cystadenoma of borderline malignancy. Rapid release of these tumor markers into circulation secondary to necrosis and degeneration of the tumor cells following torsion might account for such an unusual finding.
authors.affiliation: Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, R.O.C.
authors.forename: C C
authors.initials: CC
authors.lastname: Chuang
authors.forename: D Y
authors.initials: DY
authors.lastname: Chang
authors.forename: R J
authors.initials: RJ
authors.lastname: Chen
authors.forename: W F
authors.initials: WF
authors.lastname: Cheng
authors.forename: S N
authors.initials: SN
authors.lastname: Chow
authors.forename: S C
authors.initials: SC
authors.lastname: Huang
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D018395:CA-19-9 Antigen / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000032:analysis; D005260:Female; D006801:Humans; D010051:Ovarian Neoplasms / Q000097:blood*; D010455:Peptides / Q000097:blood; D019396:Tissue Polypeptide Antigen; D014102:Torsion Abnormality
chemical_list: D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen; D010455:Peptides; D019396:Tissue Polypeptide Antigen