Tubo-ovarian mass with raised CA-125 in a 21-year-old female

Abstract

Introduction Peritonitis associated with fungal species Curvularia lunata seldom occurs with only five cases reported in the literature, all in middle-age patients with comorbidities undergoing dialysis. Case report A 21-year-old female who was referred to surgical oncology OPD with a diagnosis of ovarian malignancy, based on raised cancer antigen 125 (CA 125) and suspected tubo-ovarian mass (TOM) on magnetic resonance imaging (MRI). A review of the MRI showed a pelvic collection with TOM, suggestive of infective pathology. Fungal culture and mass spectroscopy of the cystic collection identified the presence of Curvularia lunata. She was treated with oral itraconazole which showed symptomatic improvement and radiological response. In the follow-up period, the patient developed chest wall swelling, aspiration and geneXpert® revealed multidrug-resistant (MDR) tuberculosis, and treatment was started. Conclusions Unusual causes of TOM and raised CA 125 should be kept in mind when dealing with young patients, as the possibility of epithelial ovarian cancer in this age is very low.

Massive serous cyst adenoma with ovarian abscess causing fatal septicaemia

“…High tumour markers can cause misdiagnosis and treatment delays. CA-125 is the specific marker for epithelial ovarian tumour; nevertheless, it can be elevated in other benign disorders such as tubo-ovarian abscess, endometriosis, fibroids, TB and liver cirrhosis 12 13. MRI is required for the identification of an abscess within an ovarian tumour.…”