Unusually High Serum Levels of CA 19-9 in an Ovarian Tumour: Malignant or Benign?

Abstract

A 55-year-old (para 3 living 3) postmenopausal female (menopause attained 10 years back) presented to the out-patient gynaecology clinic with the chief complaints of a long standing, painless yet gradually increasing in size, abdominal lump along with heaviness in abdomen for last two years and significant weight loss (almost 50%) over the past one year. There was history of loss of appetite and constipation. No significant risk factors for malignancy could be elicited from her past medical history or family history.General physical examination was unremarkable except for mild pallor and low (15) BMI. There was an abdomino-pelvic mass corresponding to 30 weeks size gravid uterus, occupying all quadrants of abdomen. It was a non-tender, variegate consistency lump with restricted mobility. Pelvic examination confirmed the same mass felt through the anterior and left fornix and a retroverted atrophic uterus was felt separately from the mass. Movements of the mass could not be transmitted to the cervix and the pouch of Douglas appeared free.

A giant ovarian mucinous tumor in a 58-year-old postmenopausal patient with persistent abdominal pain and high serum levels of CA 19-9

“…The clinical application of tumor markers, such as serum concentration of CA 125, AFP and hCG is of great help not only as diagnostic aid but also in monitoring efficacy of any treatment modality like chemotherapy, radiotherapy or surgical resection [ 4 , 7 ]. Carbohydrate antigen 19-9 (CA 19-9) (a sialylated lewis glycoprotein antigen), a commonly used marker of benign and malignant hepatobiliary and pancreatic conditions, has also been found to be raised in some ovarian neoplasms [ 8 ]. The diagnosis of epithelial ovarian cancer is difficult because the symptoms and signs are vague and nonspecific.…”

Mucinous borderline ovarian tumour with torsion and micro-invasion and associated with high serum level of carbohydrate antigen 19-9: a case report

“…In mucinous tumours, CA19-9 is more frequently elevated than CA125 or CEA (57% vs 15% vs 11%) and should be used for follow-up 9 . CA19-9 is a monosialoganglioside glycoprotein antigen related to Lewis blood group protein and is present in epithelial tissues of the pancreas and hepatobiliary tree and is often secreted by mucinous tumours of gastrointestinal tract including those of pancreas and biliary tree 1,2 . The reference range for CA19-9 is 0 to 37 U/mL.…”

“…We present a case of mucinous borderline ovarian tumour with multifocal micro-invasion and torsion and associated with very high levels of serum CA19-9 in a 41-year-old woman. Tumour markers must be taken into consideration together with clinical presentation and findings of blood tests and imaging 2 . Careful clinical judgement is important when dealing with emergency admission to manage emergency complications such as torsion.…”

miR‑3940‑5p/miR‑8069 ratio in urine exosomes is a novel diagnostic biomarker for pancreatic ductal adenocarcinoma

“…In addition to imaging studies, several biomarkers are currently used for the diagnosis of PDAC. Among them, CA19-9 is the most extensively studied biomarker, and it is known to correlate with prognosis (22); however, CA19-9 is also occasionally elevated in benign hepatobiliary diseases, pancreatitis, or other tumors, such as colorectal cancer and ovarian tumors (23,24), and the PPV in asymptomatic patients is extremely low (2,3). Therefore, many studies have attempted to find new diagnostic markers for PDAC in blood or pancreatic juice, and many studies have been focusing on miRNAs (8)(9)(10)(11)(12)(13).…”