Elevation of serum CA 125 and D-dimer levels associated with rupture of ovarian endometrioma.
BACKGROUND
Patients with endometriosis rarely have a serum CA 125 concentration >100 IU/mL. A raised plasma level of D-dimer indicates active fibrinolysis, either secondary to clot formation or primarily activated. This condition is seldom diagnosed in patients with endometriosis.


METHODS
A 53-year-old woman was referred to our institution for acute abdominal pain. Laparoscopic surgery revealed a large ovarian cyst with rupture on the left side. Preoperative laboratory tests detected high serum CA 125 and D-dimer levels. Adnexectomy was performed, resulting in a sharp decrease in serum CA 125 and D-dimer concentration. We describe the clinical course of the patient.


CONCLUSIONS
Rupture of a large ovarian endometrioma can lead to a high serum concentration of CA 125, a condition which, in addition to the detected pelvic mass, may mimic a malignant process. The increased D-dimer plasma level indicated that a ruptured endometriotic cyst can induce coagulation reactions.
Uharcek
P
P
Department of Obstetrics and Gynecology, Faculty Hospital Nitra, Spitálska 6, 949 01 Nitra, Slovakia. uharcek@gmx.net
Mlyncek
M
M
Ravinger
J
J
D018394:CA-125 Antigen / Q000097:blood*; D003937:Diagnosis, Differential; D004715:Endometriosis / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000209:etiology / Q000473:pathology / Q000601:surgery; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism*; D013509:Gynecologic Surgical Procedures; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D010048:Ovarian Cysts / Q000097:blood* / Q000150:complications / Q000473:pathology / Q000601:surgery; D012422:Rupture, Spontaneous / Q000097:blood / Q000150:complications
D018394:CA-125 Antigen; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D