Lessons to be learned: a case study approach: ascites and elevated serum CA 125 due to a pancreatic carcinoma. A diagnostic dilemma.
A 72 year-old lady with unrecognised cancer of the body of the pancreas presented with a 4-month history of progressive loss of weight and ascites. The results of laboratory investigations were either negative or within normal limits--apart from a raised serum CA 125 level; no tumour mass was detected on diagnostic imaging. She underwent exploratory laparotomy for a suspected ovarian tumour, but this proved not to be the correct diagnosis. A serum CA 19-9 level was subsequently requested and found to be significantly raised; a second contrast CT scan then showed the presence of ill-defined peri-aortic tissue. A further exploratory laparotomy was carried out in order to establish the true nature of the problem; a large pancreatic carcinoma was revealed.
Obstetrics and Gynaecology Department, East Surrey Hospital, Redhill.
A S
AS
Ahmed
M
M
Long
D
D
Donaldson
D000368:Aged; D001201:Ascites / Q000209:etiology*; D014408:Biomarkers, Tumor / Q000097:blood*; D018394:CA-125 Antigen / Q000097:blood*; D002277:Carcinoma / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D010190:Pancreatic Neoplasms / Q000097:blood / Q000150:complications / Q000175:diagnosis*
D014408:Biomarkers, Tumor; D018394:CA-125 Antigen