title: Non-Hodgkin's lymphoma presenting as a pelvic mass with elevated CA-125.
abstract: BACKGROUND
  We report a case of pelvic lymphoma with an elevated serum CA-125 level, initially misdiagnosed as ovarian carcinoma. A review of the literature is presented and a possible mechanism for CA-125 elevation in diseases other than ovarian cancer is discussed.
  
  
  METHODS
  A 50-year-old woman presented with symptoms of progressive dyspnea, early satiety, fatigue, and weight loss. Workup revealed a pelvic mass and an elevated CA-125 level. Paclitaxel and carboplatin were administered to facilitate therapy and provide symptomatic relief for a presumed bulky ovarian carcinoma. A biopsy was obtained after the initiation of chemotherapy, yielding the diagnosis of diffuse large B cell non-Hodgkin's lymphoma, stage II-B. A regimen of cyclophosphamide, doxorubicin, vincristine, and prednisone followed by radiotherapy resulted in long-term disease remission. A search of the literature revealed several clinical series describing the elevation of CA-125 in a variety of diseases, both benign and malignant.
  
  
  CONCLUSIONS
  In the setting of a newly diagnosed pelvic mass, care should be taken when interpreting an elevated CA-125 level. While ovarian cancer is high on the list of differential diagnoses, lymphoma cannot be excluded until a tissue diagnosis is obtained.
authors.affiliation: Department of Human Oncology, University of Wisconsin Hospital and Clinics, Madison, WI 53792, USA.
authors.forename: Gregory W
authors.initials: GW
authors.lastname: Allen
authors.forename: Afshin
authors.initials: A
authors.lastname: Forouzannia
authors.forename: Howard H
authors.initials: HH
authors.lastname: Bailey
authors.forename: Steven P
authors.initials: SP
authors.lastname: Howard
mesh_terms: D018394:CA-125 Antigen / Q000097:blood*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000097:blood / Q000175:diagnosis*; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000097:blood / Q000175:diagnosis
chemical_list: D018394:CA-125 Antigen