High levels of CA125 (over 1,000 IU/ml) in patients with gynecologic disease and no malignant conditions: three cases and literature review

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Three cases of benign gynecologic conditions (uterine myoma and endometrioma) presented with CA125 levels over 1,000 IU/ml, highlighting the need for auxiliary data in differential diagnosis.

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This paper reports three clinical cases in which women with benign gynecologic conditions and pelvic masses had very high serum CA125 levels (>1,000 IU/ml), initially leading to concern for ovarian cancer or leiomyosarcoma. Using clinical data from Vali-Asr hospital and subsequent histologic findings after laparotomy, the authors found uterine myoma in two cases and endometrioma in one case. The main conclusion is that CA125 levels above 1,000 IU/ml can occur in non-malignant gynecologic disease, and differential diagnosis should consider other clinical and imaging information. Relevance to endometriosis: an endometrioma case with very high CA125 is presented as one of the three patients, and the paper’s literature discussion includes prior reports of elevated CA125 in endometriosis.

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Abstract

OBJECTIVE: To report the very high serum levels of CA125 in patients with benign gynecologic disease which manifests as pelvic mass. METHODS: Clinical data of three cases with high levels of CA125 over 1,000 IU/ml and benign gynecologic conditions were gathered. in Vali-Asr hospital. RESULTS: Three patients were scheduled for laparatomy as ovarian cancer and leiomyosarcoma. Histologic results after laparatomy showed uterine myoma in two patients and endometrioma in a third patient. CONCLUSION: High levels of CA125 over 1,000 IU/ml, may be showed in other gynecologic conditions with no malignancy. So, other clinical and imaging data could be helpful for differential diagnosis of these patients.
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Abstract

Objective To report the very high serum levels of CA125 in patients with benign gynecologic disease which manifests as pelvic mass.

Methods

Clinical data of three cases with high levels of CA125 over 1,000 IU/ml and benign gynecologic conditions were gathered. in Vali-Asr hospital.

Results

Three patients were scheduled for laparatomy as ovarian cancer and leiomyosarcoma. Histologic results after laparatomy showed uterine myoma in two patients and endometrioma in a third patient.

Conclusion

High levels of CA125 over 1,000 IU/ml, may be showed in other gynecologic conditions with no malignancy. So, other clinical and imaging data could be helpful for differential diagnosis of these patients. Similar content being viewed by others

References

Bast RC Jr, Badgwell D, LuZ, Marquez R et al (2005) New tumor markers: CA125 and beyond Int J Gynecol Cancer 15(3):274–281 Diamandis EP, Scorials A, Facchioli S et al (2003) Human kallikrein 6 (hK6): A new potential biomarker for diagnosis and prognosis of ovarian carcinoma. J Clin Oncol 21:1035–1043 Li HJ, Shen K, Lang JH, Wu M, Hung HF et al (2003) Benign ovarian tumor with ascitis and high serum levels of CA125: report of 3 casess. Zhanghua FU Chun Ke Za Zhi 38(3):147–149 Shian CS, Chang MY, Chiang CH, Hsieh CC, Hsich TT (2003) Ovarian endometrioma associated with very high serum CA125 levels. Chang Gung Med J 26(9):695–699 Phupong V, Chen O, Ultchaswadi P (2004) High level of CA125 due to large endometrioma. J Med Assoc Thai 87(9):1108–1111 Nikolic B, Mitrovic A, Lazic J (2006) Mean of CA125 in making therapy decisison in adnexal inflammatory tumors. Bosn J Basic Med SCI 6(2):3–96 Chamande SA, Eleonu B, Hamid AM (1996) High levels of CA125 in a case of a parasitic leiomyoma presenting as an abdominal mass. Gynecologic Oncology 61(2):297–298 Vieira SC, Pimental LH, Ribrro JC, de Andrade Note AF, de Santana Jo (2003) Meigs syndrome with elevated CA125:case report. Sao Paulo Med J 121(5):21–22 Dawood MY, Khan Dawood FS (1994) Plasma insulin like growth factor-I, Ca125, estrogen, progesterone in women with leiomyomas. Fertil Stril 61:617–621 vander Spuy ZM, Wood M, Freggen G, Salie Hendricks M (1993) Serum CA125 concentration in women with endometriosis or uterine fibroids treated with GNRH-agonists analogues. S Afr Med J 83:510–513 Mehmet Yilmazer, Murat Sonmezer, Mete Gungor, Veysel Fenkci, Serhan Cevrioglu (2003) Unusually elevated serum carbohydrate antigen 125 (Ca125) and CA19-9 levels as a result of unruptured bilateral endometrioma. Aust NZ J Obstet Gynaecol 43(4):329 Johansson J, Santala M, Kauppila A (1998) Explosive rise of serum CA125 following the rupture of ovarian endometrioma. Hum Reprod 13:3503–3504 Kashyap RJ (1999) Extremely elevated serum CA125 due to endometriosis. Aust NZ J Obstet Gynaeco l39:269–270 Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Ghaemmaghami, F., Karimi Zarchi, M. & Hamedi, B. High levels of CA125 (over 1,000 IU/ml) in patients with gynecologic disease and no malignant conditions: three cases and literature review. Arch Gynecol Obstet 276, 559–561 (2007). https://doi.org/10.1007/s00404-007-0381-x Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s00404-007-0381-x

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Condition tags

endometriosisendometrioma

MeSH descriptors

CA-125 Antigen Endometrial Neoplasms Endometriosis Leiomyoma Uterine Neoplasms Adult CA-125 Antigen Diagnosis, Differential Endometrial Neoplasms Endometrial Neoplasms Endometrial Neoplasms Endometriosis Endometriosis Endometriosis Female Humans Leiomyoma Leiomyoma Leiomyoma Middle Aged

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