Elevation of carcinoembryonic antigen and CA-125 in a patient with multivisceral tuberculosis.
A case of a middle-aged African-American woman with weight loss, ascites, a bilateral pleural effusion with no infiltrate, and a clinical diagnosis of a metastatic gynecological tumor is presented. Her carcinoembryonic antigen (CEA) and CA-125 levels were elevated (400 micrograms/L and 331 micrograms/L, respectively). She underwent an exploratory laparotomy and a dilation & curettage for biopsies and cultures. Pathological examination showed Langhans' type giant cells on peritoneal biopsy. An endometrial curette biopsy showed granulomatous endometritis and acid-fast bacilli. Cultures grew Mycobacterium tuberculosis. The patient presented with a fibroid tumor that could have contributed to her elevated CA-125 level, but after antituberculous treatment was started and tumor markers were repeated after 1 year, the CEA level decreased to 1.2 micrograms/L and CA-125 to 9 micrograms/L without surgical resection of the tumor. A review of the literature revealed only three cases in which patients had elevated CA-125 in multivisceral tuberculosis. No cases were reported in which both CEA and CA-125 levels were elevated in multivisceral tuberculosis. Possible causes of elevated CEA and CA-125 levels are discussed.
Mansour
M
M
Department of Medicine, Interfaith Medical Center, Brooklyn, New York, USA.
Linden
E R
ER
Colby
S
S
Posner
G
G
Marsh
F
F
D000995:Antitubercular Agents / Q000627:therapeutic use; D018394:CA-125 Antigen / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood*; D005260:Female; D006801:Humans; D007889:Leiomyoma / Q000097:blood / Q000150:complications; D008875:Middle Aged; D014385:Tuberculosis, Gastrointestinal / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D014594:Uterine Neoplasms / Q000097:blood / Q000150:complications
D000995:Antitubercular Agents; D018394:CA-125 Antigen; D002272:Carcinoembryonic Antigen