Benign gynecologic conditions associated with a CA-125 level > 1,000 U/mL. A case report

BACKGROUND: CA-125 was initially investigated as a marker of ovarian cancer. However, various studies have noted that it can be minimally elevated in benign conditions. CASE: A case of CA-125 > 1,000 U/mL was associated with benign gynecologic conditions. A 37-year-old woman with a history of endometriosis and premature ovarian failure underwent hormonal therapy for donor in vitro fertilization. After an unsuccessful cycle, severe dysmenorrhea developed. Investigation revealed a CA-125 level of 1,036 U/mL and a uterine mass. On exploratory laparotomy, cystic adenomyosis and uterine endometriosis was found. After excision of these areas, the CA-125 levels returned to normal. In this case, cystic adenomyosis and endometriosis of the uterine serosa were responsible for the elevated CA-125 level. CONCLUSION: Very high levels of CA-125 are not always associated with a malignant process.