Pelvic endometriosis mimicking advanced ovarian cancer: Presentation with pleural effusion, ascites, and elevated serum CA 125 level

1995 ◽  
Vol 173 (3) ◽  
pp. 966-967 ◽  
Author(s):  
Thomas J. Myers ◽  
Bruno Arena ◽  
Cornelius O. Granai
Keyword(s):  
Ovarian Cancer ◽  
Pleural Effusion ◽  
Elevated Serum ◽  
Advanced Ovarian Cancer ◽  
Ca 125 ◽  
Pelvic Endometriosis

Early-stage ovarian carcinoma combined with pulmonary tuberculosis mimicking advanced ovarian cancer: a case report

2004 ◽  
Vol 14 (5) ◽  
pp. 1007-1011
Author(s):  
C.-H. Chen ◽  
C.-Y. Huang ◽  
S.-N. Chow
Keyword(s):  
Ovarian Cancer ◽  
Pulmonary Tuberculosis ◽  
Early Stage ◽  
Elevated Serum ◽  
Advanced Ovarian Cancer ◽  
Stage Iv ◽  
Malignant Cell ◽  
Cytotoxic Chemotherapy ◽  
Ca 125 ◽  
Lung Lesions

In patients of ovarian cancer combined with multiple pulmonary nodules, the diagnosis of metastatic ovarian cancer is always considered. However, benign pulmonary conditions can be discovered instead. An 80-year-old female presented with a rapidly growing ovarian mass, elevated serum CA-125, and multiple pulmonary varying-sized nodular lesions. The pretreatment workup of her lung lesions failed to show a malignant cell, and it also failed to show any evidence of tuberculosis or other infectious diseases. After surgery, her disease was allotted to ‘stage IV’ epithelial ovarian cancer and adjuvant cytotoxic chemotherapy was then used. However, her sputum culture showed positive growth of Mycobacterium tuberculosis 4 weeks later. For fear of reactivation of pulmonary tuberculosis, the anticancer cytotoxic chemotherapy was postponed and the antituberculous treatment was given instead. After 6-month course of antituberculous therapy, no active lung lesion was detectable. In conclusion, infectious or inflammatory conditions can mimic metastatic disease and therefore add to the difficulty of stage determination. We recommend that there must be positive cytologic or pathologic results of lung lesions to allot a case of ovarian cancer to stage IV. Furthermore, whenever pulmonary lesions are seen on imaging, the possibility of diagnoses other than metastatic ovarian cancer should always be considered.

scholarly journals Bilateral Ovarian Fibrothecoma Associated with Ascites, Bilateral Pleural Effusion, and Marked Elevated Serum CA-125

2013 ◽  
Vol 2013 ◽  
pp. 1-5
Author(s):  
Védi André Serges Loué ◽  
Eléonore Gbary ◽  
Sylvanus Koui ◽  
Bédi Akpa ◽  
Adélaide Kouassi
Keyword(s):  
Ovarian Cancer ◽  
Pleural Effusion ◽  
Tumor Marker ◽  
Tumor Resection ◽  
Elevated Serum ◽  
Rare Condition ◽  
Bilateral Pleural Effusion ◽  
Ca 125 ◽  
African Woman ◽  
Elevated Tumor Marker

Background. The risk of ovarian cancer is increased in the association of ovarian tumor, ascites, and hydrothorax with the significant elevated tumor marker CA-125. However, this association can be observed in a rare clinical and benign pathological entity, that is Demons-Meigs’ syndrome.Objective. To describe a rare case of Demons-Meigs' syndrome observed in our department.Methods. A black African woman of 35 years old, seventh gravida and fourth parous, underwent a total abdominal hysterectomy with bilateral salpingoophorectomy for large bilateral ovarian masses associated with significant ascites, bilateral pleural effusion, and particular highly elevated tumor marker CA-125 (1835 UI/mL) in a pronounced general alteration condition.Results. The postoperative course was uneventful characterized by a complete remission of hydrothorax and ascites with normal level of CA-125 three months after tumor excision. Histology of both masses revealed a bilateral ovarian fibrothecoma, a benign tumor of the ovary, thus confirming the diagnosis of Demons-Meigs’ syndrome.Conclusion. The Demons-Meigs syndrome, although it strongly mimics the clinical picture of malignant metastatic ovarian cancer, remains a disease with benign prognosis after surgical tumor resection. This is a rare condition that must be known and recognized by practitioners to avoid unnecessary practices.

Peritoneal tuberculosis with pelvic abdominal mass, ascites and elevated CA 125 mimicking advanced ovarian carcinoma: A series of 10 cases

2001 ◽  
Vol 11 (4) ◽  
pp. 290-294 ◽  
Author(s):  
T. Bilgin ◽  
A. Karabay ◽  
E. Dolar ◽  
O. H. Develioğlu
Keyword(s):  
Ovarian Cancer ◽  
Ovarian Carcinoma ◽  
Abdominal Mass ◽  
Gynecologic Cancer ◽  
Elevated Serum ◽  
Advanced Ovarian Cancer ◽  
Ca 125 ◽  
Peritoneal Tuberculosis ◽  
Advanced Ovarian Carcinoma ◽  
Abdominal Paracentesis

Abstract.Bilgin T, Karabay A, Dolar E, Develioğlu OH. Peritoneal tuberculosis with pelvic abdominal mass, ascites, and elevated CA 125 mimicking advanced ovarian carcinoma.Ten patients with peritoneal tuberculosis who were operated on for suspected advanced ovarian cancer during a 5-year period were analyzed. These 10 cases constituted 1.4% of the 728 new gynecologic cancer cases diagnosed and treated at our department during the same time period. Data were obtained from patients' files and pathology reports. The mean age of cases was 40.6 ± 6.1 (median 37; range 18–72). Ascites was present together with ill-defined nodularities or thickening in the Douglas pouch and/or in the adnexal areas on pelvic examination in all patients but three, who presented with well-demarcated adnexal masses of about 5 cm in diameter. All patients had elevated serum CA 125 levels with a median of 331 U/ml, (40–560 U/ml). Ultrasound and abdominopelvic CT examinations revealed omental and mesenteric thickening in addition to ascites in all patients, cystic ovarian masses or ovarian enlargement in five, and peritoneal implants in two. Abdominal paracentesis performed in the six cases in whom the findings were felt to be most inconclusive for the diagnosis of ovarian cancer revealed clear exudative fluid with benign cells. Mycobacteria could not be demonstrated on direct preparations. Tuberculosis was diagnosed at laparotomy in all. Patients received antituberculous therapy and serum CA 125 levels returned to normal within 2 months after the beginning of treatment. This case series demonstrates a high rate of misdiagnosis between advanced ovarian cancer and peritoneal tuberculosis. Whereas abdominal paracentesis is useless in ruling out peritoneal tuberculosis, and serum CA 125 levels are not helpful in the differential diagnosis, the latter marker may be useful in the follow-up of patients.

Use of CA-125 to Define Progression of Ovarian Cancer in Patients With Persistently Elevated Levels

2001 ◽  
Vol 19 (20) ◽  
pp. 4054-4057 ◽  
Author(s):  
Gordon J.S. Rustin ◽  
Maria Marples ◽  
Ann E. Nelstrop ◽  
Mohamed Mahmoudi ◽  
Tim Meyer
Keyword(s):  
Ovarian Cancer ◽  
Clinical Trials ◽  
Myocardial Infarct ◽  
Elevated Serum ◽  
Epithelial Ovarian Carcinoma ◽  
Ca 125 ◽  
Clinical Progression ◽  
False Positive Prediction ◽  
Upper Limit ◽  
Accurate Definition

PURPOSE: To determine an accurate definition for progression of ovarian cancer in patients with a persistently elevated serum CA-125. PATIENTS AND METHODS: A retrospective analysis was performed on 300 patients with epithelial ovarian carcinoma with at least one measurement of CA-125. The date of progression according to clinical or radiologic criteria was ascertained in the 88 patients with persistently elevated CA-125 levels (> 23 U/mL). This was compared with the date of progression according to CA-125, defined as the date on which the CA-125 level first increased to ≥ twice its nadir level, confirmed by a second sample also ≥ twice the nadir. RESULTS: Eighty of the 88 patients had evidence of progression by both standard and CA-125 criteria, giving a sensitivity of 94%. In six of these patients, no sample was taken to confirm CA-125 doubling. In 13 patients, CA-125 doubling occurred after the date of clinical progression. Only one patient had a false-positive prediction of progression according to CA-125; the patient died as a result of a myocardial infarct before evidence of clinical progression. CONCLUSION: In patients whose CA-125 level decreases to normal after chemotherapy, a doubling from the upper limit of normal has been shown to predict progression. In those with persistently elevated levels, doubling of CA-125 from its nadir level has now been shown to accurately define progression. If confirmed, these CA-125 criteria should be used as additional end points in clinical trials.

scholarly journals Meigs' syndrome with elevated CA 125: case report

2003 ◽  
Vol 121 (5) ◽  
pp. 210-212 ◽  
Author(s):  
Sabas Carlos Vieira ◽  
Leonardo Halley Carvalho Pimentel ◽  
José Carlos Castelo Branco Ribeiro ◽  
Argemiro Ferreira de Andrade Neto ◽  
Jerúsia Oliveira Ibiapina de Santana
Keyword(s):  
Case Report ◽  
Pleural Effusion ◽  
Ovarian Tumor ◽  
Frozen Section ◽  
Transvaginal Ultrasound ◽  
Elevated Serum ◽  
Ca 125 ◽  
Brazilian Woman ◽  
Thoracic Drainage ◽  
Benign Ovarian Tumor

CONTEXT: Meigs' syndrome consists of a benign ovarian tumor accompanied by ascites and hydrothorax. Elevated serum CA 125 levels in postmenopausal women with solid adnexal masses, ascites and pleural effusion are highly suggestive for malignant ovarian tumor. However, patients with Meigs' syndrome can also have elevated serum CA 125 levels. The authors report a case of Meigs' syndrome with elevated CA 125 level. OBJECTIVE: This is a case report of Meigs' syndrome with elevated CA 125 level. CASE REPORT: A 65-year-old Brazilian woman had presented progressive dyspnea, weight loss and decline in general condition over the 7 months preceding admission to our service. In another hospital, the patient had been submitted to thoracic drainage due to pleural effusion. With recurrence of the pleural effusion and increase in abdominal volume due to ascites and a pelvic mass, the patient sought our service. Transvaginal ultrasound showed an extensive adnexal solid mass of 16.4 x 10.8 cm located in the pelvis without exact limits, and the serum CA 125 level was elevated. With a preoperative diagnosis of ovarian carcinoma, the patient was submitted to exploratory laparotomy, which revealed a left ovarian tumor. The frozen section diagnosis was thecoma. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. The histology of the specimen confirmed the diagnosis of thecoma. The patient was asymptomatic with a normal serum CA 125 level 20 months after the operation.

Phase II study of vinorelbine in patients with pretreated advanced ovarian cancer: activity in platinum-resistant disease.

1996 ◽  
Vol 14 (9) ◽  
pp. 2546-2551 ◽  
Author(s):  
E Bajetta ◽  
A Di Leo ◽  
L Biganzoli ◽  
L Mariani ◽  
F Cappuzzo ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Confidence Interval ◽  
Cancer Patients ◽  
Response Rate ◽  
Advanced Ovarian Cancer ◽  
Dose Intensity ◽  
Ca 125 ◽  
Resistant Disease ◽  
Platinum Resistant ◽  
Exact Confidence Interval

PURPOSE The aim of the study was to evaluate the activity of vinorelbine (VNLB) in a population of advanced ovarian cancer patients, with particular attention to defining its role in platinum-resistant disease. PATIENTS AND METHODS Thirty-three patients were recruited and treated with VNLB 25 mg/m2 intravenously (IV) weekly. the median age was 53 years, performance status 0 to 2, and number of previous chemotherapy regimens two (range, one to five). Twenty-four patients were platinum-resistant; the remaining nine either were platinum-sensitive (four cases) or had undetermined sensitivity (five cases). RESULTS The mean delivered dose-intensity of VNLB was 67% of the planned level, because 60% of the cycles were delayed due to neutropenia or anemia. Four partial responses (PRs) and one complete response (CR) were observed, for an overall response rate of 15% (95% exact confidence interval, 5.1% to 31.9%). All the responses occurred in the subgroup of 24 platinum-resistant cases, in whom the response rate was 21% (95% exact confidence interval, 7.1% to 42.1%). Seven patients became stabilized on VNLB, and 27% of the cases showed a reduction in serum cancer antigen 125 (CA 125) levels. G3/G4 side effects consisted of neutropenia, anemia, and worsening of preexisting peripheral neuropathy. No treatment-related deaths occurred. CONCLUSION VNLB led to a 21% response rate in the population of heavily pretreated and platinum-resistant ovarian cancer patients. Further studies of VNLB alone or in combination with taxanes are warranted in patients with less pretreatment.

OVX1 radioimmunoassay complements CA-125 for predicting the presence of residual ovarian carcinoma at second-look surgical surveillance procedures.

1993 ◽  
Vol 11 (8) ◽  
pp. 1506-1510 ◽  
Author(s):  
F J Xu ◽  
Y H Yu ◽  
L Daly ◽  
K DeSombre ◽  
L Anselmino ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cancer Patients ◽  
Elevated Serum ◽  
Ca 125 ◽  
Serum Samples ◽  
Persistent Disease ◽  
Second Look ◽  
Normal Individuals ◽  
Positive Results ◽  
Apparently Healthy

PURPOSE At second-look surgical surveillance procedures, normal CA-125 levels can be associated with persistent disease in 50% to 60% of patients. A novel radioimmunoassay (RIA) has been evaluated for the ability to identify patients with persistent disease who have normal levels of CA-125. MATERIALS AND METHODS The OVX1 double-determinant assay used a murine monoclonal antibody to detect an epitope on a high-molecular weight mucin-like glycoprotein. RESULTS Apparently healthy individuals had serum OVX1 levels of 2.23 +/- 2.48 U/mL (mean +/- SD). Elevated serum OVX1 levels (> 7.2 U/mL) were found in 5% of 184 normal individuals and in 70% of 93 epithelial ovarian cancer patients with clinically evident disease. Among sera from these ovarian cancer patients, OVX1 was elevated in 68% of 76 samples with CA-125 levels more than 35 U/mL and in 76% of 17 samples with CA-125 levels less than 35 U/mL. In serum samples obtained at the time of positive second-look laparotomy, 59% of 41 patients with CA-125 levels less than 35 U/mL had elevated OVX1 antigen levels, whereas 41% of 22 patients with CA-125 levels more than 35 U/mL had elevated serum OVX1 levels. In patients with negative second-look laparotomies, false-positive results were eliminated by increasing the threshold of OVX1 to 10.5 U/mL. At this level, 32% of 41 patients with positive second-look operations had an elevated OVX1 level, despite a normal CA-125 level. When used in combination, CA-125 (> 35 U/mL) and OVX1 (> 10.5 U/mL) detected persistent disease in 56% of 63 patients with positive surveillance procedures, compared with 35% when CA-125 was used alone (P < .05). CONCLUSION An elevated OVX1 level can alert oncologists to the possibility that ovarian cancer has persisted, despite the return of CA-125 to a normal range.

scholarly journals A Case of Peritoneal-Pelvic Tuberculosis With Elevated CA-125; An Enigma as Ovarian Cancer

2019 ◽  
Vol 18 (2) ◽  
pp. 60-63
Author(s):  
Prakash Raj Oli ◽  
Rosy Vaidya Malla ◽  
Kavita Karmacharya
Keyword(s):  
Ovarian Cancer ◽  
Differential Diagnosis ◽  
Abdominal Pain ◽  
Young Women ◽  
Adnexal Mass ◽  
Elevated Serum ◽  
Young Lady ◽  
Ca 125 ◽  
Rare Form ◽  
Menstrual Irregularities

Peritoneal-pelvic tuberculosis is a rare form of extrapulmonary-TB mainly affecting women of 20-40 years, especially in TB endemic countries. It classically presents with abdominal pain, menstrual irregularities, adnexal mass, and elevated serum CA-125 level, creating confusion with genital malignancy, especially ovarian one leading to difficulty in its management and often leads to devastating surgeries. Here's a case of peritoneal-pelvic TB, a young lady with abdominal pain, radiologic associates and adnexal mass, and elevated serum CA-125 level is presented. So, it should always be one of the differential diagnosis of ovarian cancer especially among young women in TB endemic countries.

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