title: Imperforate hymen with elevated serum CA 125 and CA 19-9 levels.
abstract: OBJECTIVE
  To report the clinical characteristics of 14 patients with imperforate hymen and their levels of tumor markers (CA 19-9 and CA 125).
  
  
  METHODS
  Fourteen patients with imperforate hymen who followed-up between September 2006 and September 2010 in the Department of Obstetrics and Gynecology, Dicle University School of Medicine, Diyarbakir, Turkey, were evaluated retrospectively. The clinical features and the management of the patients are discussed.
  
  
  RESULTS
  The mean age of the patients was 13.8 years. All patients had primary amenorrhea and pelvic pain. The most common clinical symptoms were cryptomenorrhea in 14 patients, pelvic pain in 11, palpable abdominal mass in 6, voiding difficulties in 7, and defecation problems in 2. In 6 patients with palpable pelvic mass, the mean + standard deviation values of tumor markers were as follows: CA 125, 84.0 +/- 23.7 and CA 19-9, 162 +/- 189. One week after surgery we measured CA 125 and CA 19-9 levels once again. The postoperative mean CA 125 level was 13.8 +/- 3.6, and the mean postoperative CA 19-9 level was 17.5 +/- 3.5. Preoperative levels of CA 125 and CA 19-9 were significantly higher than those of the postoperative period (p < 0.001 for both comparisons). Six patients were treated by T-shaped incision and 8 patients by a central surgical incision through the hymenal membrane.
  
  
  CONCLUSIONS
  Diagnosis of imperforate hymen is very important before undergoing surgery in a different clinic. Many patients have seen several doctors before receiving a clear diagnosis and have had tumor markers evaluated because the presence of pelvic mass in patients suggests the possibility of a gynecologic malignancy. Imperforate hymen is one of the benign conditions that increase serum CA 125 and CA 19-9 levels and which is not listed in the classical medical textbooks. These markers are not needed for the diagnosis.
authors: Department of Obstetrics and Gynecology, Dicle University School of Medicine, Diyarbakir, Turkey. drmesak@yahoo.com
authors: Muhammet Erdal
authors: ME
authors: Sak
authors: Mehmet Siddik
authors: MS
authors: Evsen
authors: Hatice Ender
authors: HE
authors: Soydinc
authors: Sibel
authors: S
authors: Sak
authors: Ahmet
authors: A
authors: Yalinkaya
mesh_terms: D000293:Adolescent; D000568:Amenorrhea / Q000150:complications; D014408:Biomarkers, Tumor / Q000097:blood*; D018394:CA-125 Antigen / Q000097:blood*; D018395:CA-19-9 Antigen / Q000097:blood*; D002648:Child; D000013:Congenital Abnormalities; D003248:Constipation / Q000150:complications; D005260:Female; D006399:Hematocolpos / Q000150:complications; D006409:Hematometra / Q000150:complications; D006801:Humans; D006924:Hymen / Q000002:abnormalities / Q000601:surgery; D008565:Membrane Proteins / Q000097:blood*; D008599:Menstruation Disturbances / Q000097:blood* / Q000150:complications* / Q000601:surgery; D017699:Pelvic Pain / Q000150:complications; D012189:Retrospective Studies; D014555:Urination Disorders / Q000150:complications
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D018395:CA-19-9 Antigen; C451759:MUC16 protein, human; D008565:Membrane Proteins