Ovarian Endometrioma Associated with Very High Serum CA-125 Levels

The magnitude of the elevation is important and levels > 200 U/ml are potentially associated with ovarian malignancies, whereas slight increases in levels were associated with benign gynecologic conditions. However, serum CA-125 levels > 1000 U/ml have also been reported in patients with endometriosis. Herein, the authors report an additional case of high levels of CA-125 in large unruptured endometrioma. We present a patient with moderate sized bilateral ovarian endometrioma who was undergoing laparotomy and who had CA-125 levels of 3782 U/mL. Our case further emphasizes that very high levels of CA-125 are not always associated with malignant disease and no critical cutoff value for CA-125 is diagnostic of malignancy.