Ruptured ovarian endometrioma with an extreme rise in serum CA 125 level — A case report

Rani, Anju; Kapoor, Deepa

doi:10.1016/j.gynor.2012.05.005

Cited by 11 publications

(18 citation statements)

References 6 publications

(6 reference statements)

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“…Moreover, one case showed an extremely elevated level which was higher than 2000 IU/mL (18). One year later, researchers found that patients with ruptured OEs showed serum CA-125 levels that were markedly elevated at 9391 IU/ml (17). Hitoshi Kurata reported a 23-year-old woman who suffered from ruptured OE with elevated concentrations of CA-125 (9537 IU/ml) and CA19-9 (15,653 IU/ml) (19).…”

Section: Discussionmentioning

confidence: 99%

“…Ovarian endometriosis (OE) is a common type of endometrioma. Jenkins et al reported that the incidence of OE is as high as 17-44% in patients with endometriosis (6).…”

Section: Introductionmentioning

confidence: 99%

“…Some cases reported the phenomenon of extremely elevated serum CA 19-9 or CA-125 level in patients with ruptured OE (17)(18)(19)(20); however, few studies focused on the diagnostic e ciency of ruptured OE in relationship to abnormally elevated CA-125 or CA19-9 levels(21). It is essential to discriminate ruptured benign OE-which showed an extremely higher expression of CA19-9 or CA-125-from malignant ovarian tumors (22) to eliminate patients' anxiety and, more importantly, guide the optimal surgical approach.…”

Section: Introductionmentioning

confidence: 99%

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Elevated serum CA 19-9 level, combined with D-dimer, could detect the presence of ruptured ovarian endometriosis

Shuang¹,

Zhao²,

Zhang³

et al. 2020

Preprint

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Background: Ovarian endometriosis (OE) is a common type of endometrioma, which is a benign disease of gynecology. For the diagnosis of OE, ultrasonography is a very effective and straightforward. OE rupture is rare, and there is still a lack of a non-invasive and effective method for diagnosis. Elevated serum CA19-9 or CA-125 levels are typically applied as biomarkers for malignancy, besides, the CA-125 and CA19-9 levels have been recommended as a useful marker for the diagnosis of endometriosis. We aimed to clarify the clinical importance of serum CA19-9, CA-125 level, and plasma D-dimer (D-D) for detecting spontaneously ruptured ovarian endometriosis.Results: Among the 21 patients of rupture OE, 16 with a history of detected pelvic cysts, 19 claimed sudden onset of lower abdominal pain, however, only 6 patients detected fluid accumulation in the cul-de-sac by ultrasound. For the serological investigation, the serum CA19-9 was significantly elevated in the ruptured OE group (343.09±367.67 U/ml vs. 36.84±40.01U/ml, P<0.0001). D-D was also abnormally elevated in the ruptured OE group (3.39±4.90 mg/L vs. 0.43 ± 0.29 mg/L, P <0.0001). The AUC value for the combined CA19-9 and D-D was 0.975 (95% CI, 0.939 -0.993), with the highest specificity of 96.69, and sensitivity of 85.71.Conclusion: The combination of serum CA19-9 and plasma D-D levels could serve as an effective biomarker to identify patients with spontaneously ruptured ovarian endometriosis pre-operatively in the context of clinical assessment.

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Section: Discussionmentioning

confidence: 99%

“…Ovarian endometriosis (OE) is a common type of endometrioma. Jenkins et al reported that the incidence of OE is as high as 17-44% in patients with endometriosis (6).…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Elevated serum CA 19-9 level, combined with D-dimer, could detect the presence of ruptured ovarian endometriosis

Shuang¹,

Zhao²,

Zhang³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…The raised levels of CA-125 must be due to large surface areas of endometriomas and endometriosis induced peritoneal inflammation. 35 Infertile women are 6 to 8 times more likely to have endometriosis than fertile women. 36 Many mechanisms like distorted pelvic anatomy, endocrine and ovulatory abnormalities, altered peritoneal function, and altered hormonal and cellmediated functions in the endometrium have been proposed to explain infertility in endometriosis cases but no definite conclusion has been reached.…”

Section: Discussionmentioning

confidence: 99%

Endometriosis: an enigmatic disease with many faces

Limbachiya¹,

Agrawal²

2017

Int J Reprod Contracept Obstet Gynecol

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Endometriosis is a benign disease defined by the presence of the endometrial glands and stroma outside of the uterus, both at pelvic and extra pelvic sites. We are reporting 4 unusual cases of endometriosis that are unique on their own due to site of endometriosis, presenting symptoms, complications and treatment. Endometriosis was present at post caesarean scar site in one case, at vault site in another case, in bladder in third case and in the last case it caused frozen pelvis with hydroureter, hydronephrosis and possibly infertility. All four patients have been treated laparoscopically and have been following up with no recurrence of its symptoms. The purpose of this article is to create awareness among Doctors about endometriosis, which is more common than previously thought as. Endometriosis has been rightly summed up in the phrase “The clock is definitely ticking, as we know millions of women still live lives awash in anguish, just as they did thousands of years ago and just as they will centuries from now unless we steer ourselves faster toward the long-elusive cure. Four thousand years is long enough; the time has come to end the empire of endometriosis”.

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“…The incidence of ovarian cancer is low in young women and epithelial ovarian cancers are not known to occur before menarche, and most of them (though rare) are germ cell tumor, juvenile granulosa cell tumor and serous borderline tumors. Age specific incidence is 40/100,000 by the age of 50 and rises to 50 per 100,000 women by the age of 65 years (61) . ANOVA analysis of this study revealed a significant lower hemoglobin level among patients with malignant pelvic type as compared to healthy women (P<0.05).…”

Section: B Amentioning

confidence: 99%

Clinical Significance of Thrombocytosis and CA125 as Predictor of Malignancy in Gynecological Pelvic Mass

Salamit¹

2018

Int.J.Curr.Res.Aca.Rev.

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Article InfoWe attempted to determine the increasing of platelet counts (> 450.000 /microliter) and Cancer Antigen 125 (CA125) serum level (> 35 U/mL) as useful tools for predicting and confirming malignancy in gynaecological pelvic mass. A prospective unmatched hospital based case-control study carried out about One hundred & ten women were enrolled in our study, divided into two group 60 women were control group (free of gynaecological pelvic mass) which were considered as -eligible entrants‖ into the study. Other group include 50 women above 15 years old with gynaecological pelvic mass were all candidate for laparotomy and using different diagnostic methods like clinical examination, imaging techniques (U/S, CT scan and MRI) and laboratory test (platelet count, CA125 and Histopathology). The data of those were subjected to statistical analysis (sensitivity, specificity, accuracy, NPV and PPV) which calculated to considered if it is statistically significant or not. Serum CA125 and blood platelets count were tested for validity when used as a test to predict a diagnosis of malignancy in gynaecological pelvic mass differentiating it from benign gynaecological pelvic mass. Both tests showed a very high validity in diagnosis (ROC area >0.95), with serum CA125 showing a marginally higher validity (ROC area larger by 0.017 only). Both ROC areas were significantly higher than the 0.5 area associated with an equivocal test. Platelets counts had a perfect cut-off value of ≥385.000 All study subjects with a blood platelets count equal or greater than 385.000 were malignant, while everybody below this cut-off value was healthy. For serum CA125 testing negative at the highest sensitivity (100% sensitive) cut-off value of (≥27.1( would excluded a possible diagnosis of malignancy in favor of being healthy with 100% confidence. The optimum cut-off value is ≥41.7, which is also the 100% specific and thus 100% diagnostic cut-off value. Both blood platelet count (≥ 385 X 10 3 microlitter) & serum level of CA125 (≥ 41.7 U/mL) are useful predictor tools to confirm malignancy in gynecological pelvic mass.

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Ruptured ovarian endometrioma with an extreme rise in serum CA 125 level — A case report

Abstract: ► CA 125 is the most useful tumor marker for epithelial ovarian carcinoma. ► Very high serum CA 125 level does not necessarily indicate ovarian malignancy. ► Rapidly rising and persistent levels of CA 125 may be consistent with benign disease.

Cited by 11 publications

References 6 publications

Elevated serum CA 19-9 level, combined with D-dimer, could detect the presence of ruptured ovarian endometriosis

Elevated serum CA 19-9 level, combined with D-dimer, could detect the presence of ruptured ovarian endometriosis

Endometriosis: an enigmatic disease with many faces

Clinical Significance of Thrombocytosis and CA125 as Predictor of Malignancy in Gynecological Pelvic Mass

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