High level of CA 125 due to large endometrioma.
BACKGROUND
CA 125 is a tumor-associated antigen. Its high levels are usually associated with ovarian malignancies, whereas smaller increases in the levels were associated with benign gynecologic conditions. The authors report a high level of CA 125 in a case of large ovarian endometrioma.


METHODS
A 45-year-old nulliparous Thai woman, presented with an increase of her abdominal girth for 7 months. Transabdominal ultrasonogram demonstrated a large ovarian cyst and multiple small leiomyoma uteri, and serum CA 125 level was 1,006 U/ml. The preoperative diagnosis was ovarian cancer with leiomyoma uteri. Exploratory laparotomy was performed. There were a large right ovarian endometrioma, small left ovarian endometrioma and multiple small leiomyoma. Total abdominal hysterectomy and bilateral salpingo-oophorectomy was performed and histopathology confirmed the diagnosis of endometrioma and leiomyoma. The serum CA 125 level declined to non-detectable at the 4th week. She was well at discharge and throughout her 4th week follow-up period


CONCLUSIONS
Although a very high level of CA 125 is associated with a malignant process, it can also be found in benign conditions such as a large endometrioma. The case emphasizes the association of high levels of CA 125 with benign gynecologic conditions.
Phupong
Vorapong
V
Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Thailand. vorapong.p@chula.ac.th
Chen
Orawan
O
Ultchaswadi
Pornthip
P
D018394:CA-125 Antigen / Q000097:blood*; D004715:Endometriosis / Q000097:blood* / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D010049:Ovarian Diseases / Q000097:blood* / Q000000981:diagnostic imaging / Q000601:surgery; D014463:Ultrasonography
D018394:CA-125 Antigen