Elevation of Serum CA 125 and D-Dimer Levels associated with Rupture of Ovarian Endometrioma

Peter Uharček, M Mlynček, J. Ravinger
In: The International Journal of Biological Markers · 2007 · vol. 22(3) , pp. 203–205 · doi:10.1177/172460080702200307 · W4244618177
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This case report describes a patient whose ruptured ovarian endometrioma led to elevated serum CA 125 and D-dimer levels, mimicking malignancy and indicating induced coagulation.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This 2007 case report describes a 53-year-old woman with acute abdominal pain in whom preoperative laboratory testing showed markedly elevated serum CA 125 and D-dimer levels. Laparoscopic surgery identified a large ruptured left ovarian endometrioma, and after adnexectomy both CA 125 and D-dimer levels decreased sharply. The authors conclude that rupture of a large endometrioma can raise CA 125 to levels that may mimic malignancy and that the D-dimer elevation reflects coagulation/fibrinolysis activity triggered by an endometriotic cyst rupture, while noting this is based on a single patient experience. This paper is centrally about endometriosis — specifically the biomarker changes (CA 125 and D-dimer) associated with rupture of an ovarian endometrioma.

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Abstract

Background Patients with endometriosis rarely have a serum CA 125 concentration >100 IU/mL. A raised plasma level of D-dimer indicates active fibrinolysis, either secondary to clot formation or primarily activated. This condition is seldom diagnosed in patients with endometriosis. Case report A 53-year-old woman was referred to our institution for acute abdominal pain. Laparoscopic surgery revealed a large ovarian cyst with rupture on the left side. Preoperative laboratory tests detected high serum CA 125 and D-dimer levels. Adnexectomy was performed, resulting in a sharp decrease in serum CA 125 and D-dimer concentration. We describe the clinical course of the patient. Conclusion Rupture of a large ovarian endometrioma can lead to a high serum concentration of CA 125, a condition which, in addition to the detected pelvic mass, may mimic a malignant process. The increased D-dimer plasma level indicated that a ruptured endometriotic cyst can induce coagulation reactions.

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endometriosisendometrioma

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