Laparoscopic Management of Peritonitis Due to a Ruptured Ovarian Endometrioma with Extremely High Levels of Cancer Antigen–125 and Cancer Antigen–19-9
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This case report describes the laparoscopic management of a ruptured ovarian endometrioma presenting with peritonitis and extremely high CA-125 and CA-19-9 levels, which mimicked ovarian cancer.
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Abstract
Background: An endometrioma is a common gynecologic condition, usually defined as a growth of endometrial tissue outside the uterine cavity. Rarely, an ovarian endometrioma can rupture spontaneously, while the clinical significance of serum cancer antigen (CA)–125 and CA–19-9 levels might be that they are indicators of the presence of that endometrioma. Case: A 23-year-old nulliparous woman had acute abdominal pain with peritonitis. Computed tomography showed a left ovarian mass ∼12 cm with fluid collection in the intra-abdominal cavity and thickening of the omentum. These findings appeared to be ovarian cancer with ascites and omental caking. The patient's CA-125 and CA–19-9 levels were 25,149 U/mL and 5379 U/mL, respectively. Results: A laparoscopic view showed a ruptured left ovarian endometrioma with diffused chocolate content over the surface of the liver, omentum, and intra-abdominal cavity. Laparoscopic enucleation of the left ovary, peritoneal irrigation, and adhesiolysis were performed. A pelvic mass score, such as a risk of malignancy index, could not be used to detect malignant ovarian cancer due to the patient's high levels of CA-125 and CA–19-9. Conclusions: High-combination CA-125 and CA–19-9 concentrations could indicate the presence of a ruptured endometrioma. Laparoscopy—performed by an experienced endoscopist—is an efficient procedure for confirming a diagnosis and operating safely to remove the mass.
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Cites (2)
- Endometriosis and ovarian cancer 2014
- Retrospective evaluation of tumor markers in ovarian mature cystic teratoma and ovarian endometrioma 2012
Cited by (3)
- Bio-nanocomposite based highly sensitive and label-free electrochemical immunosensor for endometriosis diagnostics application 2021
- Diagnostic Clues for Women with Acute Surgical Abdomen Associated with Ruptured Endometrioma 2023
- Spontaneous Rupture of Huge Ovarian Endometrioma and Its Successful Laparoscopic Management: A Case-Study and Review of Literature 2022
References (8)
- Endometriosis and ovarian cancer via openalex
- Retrospective evaluation of tumor markers in ovarian mature cystic teratoma and ovarian endometrioma via openalex
- W1969663509 via openalex
- W1987438172 via openalex
- W2021066957 via openalex
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Cited by (3)
- Diagnostic Clues for Women with Acute Surgical Abdomen Associated with Ruptured Endometrioma 2023
- Spontaneous Rupture of Huge Ovarian Endometrioma and Its Successful Laparoscopic Management: A Case-Study and Review of Literature 2022
- Bio-nanocomposite based highly sensitive and label-free electrochemical immunosensor for endometriosis diagnostics application 2021
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- openalex
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- unpaywall
- last seen: 2026-09-15T06:33:26.365676+00:00
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