Extremely elevated serum CA125 and CA19-9 levels following the rupture of ovarian endometrioma: a case report

Hüseyin Cengiz, Şükrü Yıldız, Levent Yaşar, Murat Ekin, Cihan Kaya
In: Gaziantep Medical Journal · 2012 · vol. 18(3) , pp. 189 · doi:10.5455/gmj-30-2012-93 · W2151190757
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-07 ⓘ

This case report describes extremely elevated serum CA125 and CA19-9 levels in a patient experiencing a rupture of bilateral large ovarian endometriomas with subsequent intra-abdominal fluid overflow.

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This case report examined a patient with bilateral large ovarian endometriomas that ruptured, leading to an “explosive” overflow of thick chocolate cyst fluid into the abdominal cavity. The authors measured extremely elevated serum tumor markers, reporting abnormally high plasma CA125 and CA19-9 following rupture. The key finding was that CA125 and CA19-9 can become markedly elevated in the context of benign endometriosis after endometrioma rupture. This paper is centrally about endometriosis — it documents a case of CA125 and CA19-9 elevation triggered by rupture of an ovarian endometrioma.

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Abstract

In gynecology, the serum CA125 and CA19-9 levels are elevated in patients with malignant and benign conditions especially in ovarian tumors. Although endometriosis is a benign condition, increased levels of the tumor markers CA125 and CA19-9 may be seen. We present a case demonstrated that abnormally high levels of plasma CA125 and CA19-9 encountered in bilaterally large ovarian endometrioma with rupture and the overflow of the thick chocolate cyst fluid throughout the abdominal cavity.
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Extremely elevated serum CA125 and CA19-9 levels following the rupture of ovarian endometrioma: a case report Ovaryan endometrioma rüptürünü takiben anormal düzeyde yükselen CA125 ve CA19-9 seviyeleri: olgu sunumu DOI: https://doi.org/10.5455/GMJ-30-2012-93Keywords: CA125, CA 19-9, endometriosis, ruptureAbstract In gynecology, the serum CA125 and CA19-9 levels are elevated in patients with malignant and benign conditions especially in ovarian tumors. Although endometriosis is a benign condition, increased levels of the tumor markers CA125 and CA19-9 may be seen. We present a case demonstrated that abnormally high levels of plasma CA125 and CA19-9 encountered in bilaterally large ovarian endometrioma with rupture and the overflow of the thick "chocolate" cyst fluid throughout the abdominal cavity. References Bast RCJ, Feeney M, Lazarus H. Reactivity of a monoclonal antibody with human ovarian carcinoma. J Clin Invest 1981;68:1331–37. Ohshio G, Yamaki K, Imamura T, Suwa H, Chang CY, Wada H, et al. Distribution of the carbohydrate antigens, DU-PAN- 2 and CA19-9, in tumors of the lung. Tumori 1995;81:67–73. Del Villano BC, Brennam S, Brock P, Bucher C, Liu V, McClure M, et al. Radioimmunometric assay for a monoclonal antibody-defined tumor marker, CA19-9. Clin Chem 1983;29:549–52. Johansson J, Santala M, Kauppila A. Explosive rise of serum CA 125 following the rupture of ovarian endometrioma. Hum Reprod 1998;13:3503–4. Kashyap RJ. Extremely elevated serum CA125 due to endometriosis. Aust New Zealand J Obstet Gynaecol 1999;39:269–70. Kammerer-Doak DN, Magrina JE, Nemiro JS, Lidner TK. Benign gynecologic conditions associated with a CA-125 level > 1000 U/ml. A case report. J Reprod Med 1996;41:179–82. Guerriero S, Ajossa S, Caffiero A, Mais V. Relationship between abnormally high levels of plasma CA 125 and resolution of acute pelvic pain in two women with endometrioma. Gynecol Obstet Invest 1995;40:61–3. Abad A, Cazorla E, Ruiz F, Aznar I, Asins E, Llixiona J. Meigs’ syndrome with elevated CA125: case report and review of the literature. Eur J Obstet Gynecol Reprod Biol 1999; 82:97–9. Harada T, Kubota T, Aso T. Usefulness of CA19-9 versus CA125 for the diagnosis of endometriosis. Fertil Steril. 2002;78:733–9. Kurata H, Sasaki M, Kase H, Yamamoto Y, Aoki Y, Tanaka K. Elevated serum CA125 and CA19-9 due to the spontaneous rupture of ovarian endometrioma. Eur J Obstet Gynecol Reprod Biol. 2002;105(1):75–6. Downloads Published How to Cite Issue Section License Copyright (c) 2023 European Journal of Therapeutics This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. The content of this journal is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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