scholarly journals A diagnostic approach for differentiating abdominal tuberculosis from ovarian malignancy: a case series and literature review

2019 ◽  
Vol 13 (S11) ◽  
Author(s):  
Moh Nailul Fahmi ◽  
Annisaa Pelita Harti
Keyword(s):  
Ovarian Cancer ◽  
Extrapulmonary Tuberculosis ◽  
Clinical Manifestations ◽  
Case Series ◽  
Abdominal Tuberculosis ◽  
Diagnostic Approach ◽  
Ca 125 ◽  
Imaging Features ◽  
Ovarian Malignancy ◽  
Cancer Antigen 125

Abstract Background Abdominal tuberculosis is an uncommon variant of extrapulmonary tuberculosis. It accounts for 3.5% of extrapulmonary tuberculosis. Diagnosis of abdominal tuberculosis is still a challenge due to its non-specific symptoms. Abdominal tuberculosis and ovarian cancer may show similar symptoms, laboratory and imaging features. The goal of our report is to emphasize for the need of a diagnostic approach based on clinical manifestations, laboratory, imaging findings, and additional tests for considering a diagnosis of abdominal tuberculosis rather than ovarian cancer. Case presentation We report 3 cases of abdominal tuberculosis in our Onco-gynaecology Division, Department of Obstetrics and Gynaecology, Sardjito Hospital, Yogyakarta, Indonesia in 2018 which were previously diagnosed as ovarian malignancy and managed surgically. All of our patients experienced abdominal pain and enlargement but only two of them had significant weight loss. The general symptoms were typically found in onco-gynaecology patients, especially in those with ovarian malignancy. Ultrasound examination showed multilocular masses, 2 of them with solid parts and ascites. Cancer antigen 125 (CA-125) levels were found increasing in those three patients. All of them were treated surgically and diagnosis of abdominal tuberculosis was established through the histopathological result of tissue biopsy. Based on our cases and literature, we consider the need of a diagnostic approach to differentiate abdominal tuberculosis from ovarian malignancy, an attempt to avoid unnecessary invasive procedures that put burden risk for the patients. Conclusion Minimally invasive tests to establish the diagnosis of abdominal tuberculosis should be optimized to reduce the burden risk of laparotomy. Careful diagnostic steps should be followed to avoid wrong diagnosis.

CA 125 and TB

2021 ◽  
Vol 14 (1) ◽  
pp. e238199
Author(s):  
Mirae Park ◽  
Ranju Dhawan ◽  
Elizabeth Whittaker ◽  
Onn Min Kon
Keyword(s):  
Extrapulmonary Tuberculosis ◽  
Abdominal Tuberculosis ◽  
Needle Aspiration ◽  
Tumour Marker ◽  
Endobronchial Ultrasound ◽  
Ca 125 ◽  
Cancer Antigen 125 ◽  
Cancer Antigen ◽  
Transbronchial Needle Aspiration ◽  
Specific Symptoms

We present two unusual presentations of extrapulmonary tuberculosis (EPTB) and more specifically intra-abdominal tuberculosis (TB). These cases were initially suspicious for ovarian cancer, presenting with non-specific symptoms, ultrasound-confirmed ascites and elevated cancer antigen 125 tumour marker (CA 125). However, in both cases chest imaging demonstrated enlarged mediastinal nodes amenable to endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), which confirmed the diagnosis of TB. Both cases were successfully treated with quadruple TB therapy.

scholarly journals Determination of Serum CA125 and evaluate its efficiency as screening tool For Early Detection of Ovarian Tumors

2015 ◽  
Vol 12 (1) ◽  
pp. 55-62
Author(s):  
Baghdad Science Journal
Keyword(s):  
Ovarian Cancer ◽  
Early Detection ◽  
Screening Tool ◽  
Stage I ◽  
Ca 125 ◽  
Benign Tumors ◽  
Cancer Antigen 125 ◽  
Ovarian Cancers ◽  
Serum Ca125 ◽  
Low Sensitivity

Epithelial ovarian cancer is the leading cause of cancer deaths in women. To date, an effective screening tool for ovarian cancer has not been identified Several clinical and biological factors including serum cancer antigen 125 (CA- 125) have been assessed for prognostic and predictive relevance CA-125 is an epithelial marker derived from coelomic epithelium. It is elevated in 90% of advanced ovarian cancers and in 50% of early ovarian cancers while 20% of ovarian cancers have low or no expression of CA- 125 CA-125 concentrations were measured by Mini Vidas test (VIDAS CA125 II / BIOMERIEUX / France). The median CA-125 levels were significantly higher in the sera of ovarian cancer patients than in those with benign tumors and in healthy controls. However in correlation with stages the results showed that Patients with stage II have highly significant differences in level of serum CA125 compare with stage I in and stage III.CA125 showed low sensitivity to detect stage I carcinoma of the ovary which limits its value as an initial screening tool therefore combining of CA125 with other markers might enable improved early detection of ovarian cancer as compared with use of this marker alone.

scholarly journals Diagnostic performance of CA 125, HE4, and risk of Ovarian Malignancy Algorithm for ovarian cancer

2018 ◽  
Vol 33 (1) ◽  
pp. e22624 ◽  
Author(s):  
Boyeon Kim ◽  
Yongjung Park ◽  
Banseok Kim ◽  
Hyo Jun Ahn ◽  
Kyung-A Lee ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Diagnostic Performance ◽  
Ca 125 ◽  
Ovarian Malignancy

scholarly journals Immunohistochemical Study of CA 125 in Surface Epithelial Tumors of Ovary in Correlation with Serum Levels

2020 ◽  
Vol 7 (7) ◽  
pp. A355-360
Author(s):  
Karishma Pillarisetty ◽  
Savithri Ravindra
Keyword(s):  
Ovarian Cancer ◽  
Ovarian Neoplasms ◽  
Serum Levels ◽  
Tissue Expression ◽  
Epithelial Differentiation ◽  
Ca 125 ◽  
Cancer Antigen 125 ◽  
Cancer Antigen ◽  
Epithelial Tumors ◽  
Wide Range

Background: Ovarian carcinoma is the 4th leading cancer among women in India. Primary ovarian neoplasms exhibit a wide range of histopathological patterns and tumors with epithelial differentiation are most frequent. Among malignant tumors, most common histological type is serous adenocarcinoma whose diagnosis is established in advanced stages of disease in approximately 75% of patients. The most widely used tumor marker in ovarian cancer, often considered “gold standard” is Cancer Antigen125. Cancer Antigen 125 is a high molecular weight glycoprotein which is raised in approximately 90% of patients with advanced epithelial ovarian cancer.   Methods: A 2 year prospective study included 81 cases of ovarian neoplasms with surface epithelial differentiation.  The specimens were fixed in 10% formalin, routinely processed. Sections of 4-5 microns thickness were obtained from the paraffin block and stained with Hematoxylin & Eosin. The tumors were categorised according to WHO classification.  Immunohistochemical analysis of Cancer Antigen 125 was done in all malignant & borderline tumors.   Result: A total of 81 cases were studied. There were 15 cases with elevated serum Cancer Antigen 125 levels. Of these 8 showed positive tissue expression. The sensitivity of serum Cancer Antigen 125 was 68.75% & its specificity was 93.8%.   Conclusion: Serum Cancer Antigen 125 is elevated in ovarian tumors especially in malignant surface epithelial tumors & more commonly in serous cystadenocarcinoma. There was a good correlation between serum levels & tissue expression of Cancer Antigen 125.

scholarly journals One-Stop Clinic for Patients with Suspected Ovarian Cancer Pathway from a Retrospective Outcome Study

2020 ◽  
Author(s):  
Ayisha Adeeba Ashmore ◽  
C. Gnanachandran ◽  
I. Luqman ◽  
K. Horrocks
Keyword(s):  
Ovarian Cancer ◽  
Primary Care ◽  
Pelvic Mass ◽  
Initial Assessment ◽  
Ca 125 ◽  
Outcome Study ◽  
Ovarian Malignancy ◽  
Cancer Symptoms ◽  
Nice Guideline ◽  
One Stop

Abstract Background:Recent encouragement in early detection of cancer nationally has significantly increased the number of referrals made through the two-week wait suspected cancer pathway. In particular women with abdominal pain and bloating are frequently having their Ca-125 levels investigated for suspected ovarian cancer and this has led to a significant increase in referrals to the ovarian cancer service. We have conducted this study to help improve the efficiency in which these patients are investigated and to improve future pathways within the referral service. Methods:A retrospective observational outcome study. Data were collected from electronic documents of patients’ referrals, assessments, and clinical correspondences.The study was conducted in a tertiary gynaecology cancer centre with primary care direct referrals. The pelvic mass clinic was the clinic setup with consultation, scan and patient support was available. All patients referred by direct primary care for suspected ovarian cancer over two years with Ca-125 result. Data were collected and analysed from the pelvic mass clinic over 48 months, which was available through electronic documentation. Data included information on their consultation, ultrasound scan findings, any further intervention, surgery, and histological outcome of all patient who underwent biopsies or surgery.Results: Two hundred and eighty-six patients were referred from primary care where the NICE guideline, ‘two-week wait for ovarian cancer’, was applied. Two hundred and twenty-three patients were included in this analysis, who had a Ca-125 result reported at the time of their referral. Out of the 223 patients, 126 patients were discharged with or without a repeat Ca-125 after the initial assessment. Seventeen patients were diagnosed with cancer following the referral, but only 12 of them had a primary ovarian malignancy. Conclusion:Majority of the patients with Ca-125 of more than 35U/mL, who were referred through this pathway, did not have cancer. This message can be disseminated by primary care practitioners who may be able to reassure patients prior to their initial consultation with a gynaecologist. This review queries the future value of using Ca-125 as the basis for referrals from primary care referrals for suspected ovarian malignancy. Further studies are required to assess whether a higher Ca-125 cut off may be used as the basis of referrals for postmenopausal women. One-stop focused gynaecology ultrasound clinic (OSFGUC) where clinicians may assess patients with suspected ovarian cancer symptoms and perform ultrasound scans may be better for managing this patient population.

scholarly journals Preoperative detection of ovarian cancer by color doppler ultrasonography and CA 125

1970 ◽  
Vol 36 (2) ◽  
pp. 68-73 ◽  
Author(s):  
Fawzia Hossain ◽  
Md Nazmul Karim ◽  
Shah Md Mahfuzur Rahman ◽  
Nazreen Khan ◽  
Maruf Siddiqui ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Early Detection ◽  
Predictive Value ◽  
Ovarian Tumor ◽  
Pulsatility Index ◽  
Color Doppler ◽  
Resistance Index ◽  
Ca 125 ◽  
Ovarian Malignancy ◽  
Age Group

Purpose: Early detection of ovarian malignancy is of great clinical importance. The high mortality rate is due to the difficulties with the early detection of ovarian cancer. Current research attempted to assess the accuracy of Color Doppler Sonography and serum CA-125 level as diagnostic tool of ovarian tumor.Materials and Methods: In this cross-sectional study, 60 consecutive patients with ovarian tumor attending the Department of Obstetrics and Gynecology of BSMMU were recruited. Of the study participants 23.3% belong to 16-25 year age group, 20% belong to 26-35 years age group and 23.30% each were of 46-55 years and > 55 years age group. All the patients recruited were from in-patient department and had undergone surgery. Following excision, routine histopathology revealed 43.30% malignant (n=26) and 56.7% (n=34) benign ovarian lesion. Data were collected from the clinical history form and bimanual pelvic examination, serum CA 125 levels, estimation of Resistance index (RI), Pulsatility Index (PI), Novel Index by CDS and post-operative histo-pathological findings were then recorded. Sensitivity, specificity, accuracy, positive and negative predictive value of the diagnosis made by CDS, CA125, in the discrimination of the benign and malignant ovarian tumors was calculated. Using Receiver operative characteristics analysis the accuracy of RI, PI, CA 125 and Novel Index in the diagnosis of ovarian tumor (benign or malignant) were assessed.Results: With the Cut-off of <.5, Resistance Index is found to be capable of detecting 92% of malignant cases (sensitivity 91.7), and could detect 89% (specificity 88.9) of benign cases correctly which translates in to 90% accuracy in the diagnosis of ovarian tumor. Predictive values for positive (84.6) and negative (94.1) tests were also found to be quite high. Pulsatility index was found to be moderate accuracy (63.3%) with cutoff <1 for malignancy, however low predictive value for a positive test (38.5) questions its use. Both CA-125 and Novel Index showed similar level of sensitivity and specificity. Although Novel Index is derivative of CA125, Novel Index demonstrated better diagnostic accuracy and negative predictive value. The cutoff for CA 125 was mandated as 83.58. With the value the sensitivity is 76.9% and the specificity is 94.1%. RI is found to be more sensitive in detection of positive cases (Malignant) and CA125 is found to be more accurate in detection of negative cases (Benign). However a combination could be tried to make a better detection.Conclusion: Color Doppler ultra-sonography and CA125 excels in different tasks, the study concludes in favor of concurrent use of the methods for improving efficacy and thus early detection of ovarian malignancy. DOI: 10.3329/bmrcb.v36i2.6991Bangladesh Med Res Counc Bull 2010; 36: 68-73

High CA 125 in a Case of Abdominal Tuberculosis mimicking Ovarian Malignancy

2016 ◽  
Vol 3 (1) ◽  
pp. 51-52
Author(s):  
Iqbal Tintoiya ◽  
Nimisha Srivastava ◽  
Pratima Thamke
Keyword(s):  
Abdominal Tuberculosis ◽  
Ca 125 ◽  
Ovarian Malignancy

scholarly journals High Serum Levels of Follistatin in Patients with Ovarian Cancer

2012 ◽  
Vol 40 (3) ◽  
pp. 877-886 ◽  
Author(s):  
P Ren ◽  
F-F Chen ◽  
H-Y Liu ◽  
X-L Cui ◽  
Y Sun ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Healthy Subjects ◽  
Ovarian Tissue ◽  
Serum Levels ◽  
Tumour Marker ◽  
High Serum ◽  
Ca 125 ◽  
Ovarian Cysts ◽  
Cancer Antigen 125 ◽  
Serum Samples

OBJECTIVE: This study investigated the potential use of serum follistatin (FST) as a marker for ovarian cancer alongside serum cancer antigen-125 (CA-125). METHODS: Serum samples were collected from patients with ovarian cancer ( n = 45), benign ovarian cysts ( n = 40) or other cancers ( n = 100) and from healthy subjects ( n = 60) for the determination of FST and CA-125 levels using enzyme-linked immunosorbent assays. Expression of FST in ovarian tissue was investigated using immunohistochemical staining. RESULTS: Compared with healthy subjects and patients with benign ovarian cysts, serum FST and CA-125 levels were significantly increased in patients with ovarian cancer. Using the 95% confidence interval for the healthy subjects group as the cut-off value, tumour marker sensitivity and specificity in ovarian cancer were 53.3% and 97% for FST and 77.8% and 84% for CA-125, respectively. Tissue expression of FST protein was more pronounced in ovarian cancer than in normal ovary. CONCLUSIONS: The serum FST level was elevated in the peripheral blood of patients with ovarian cancer and has potential as a tumour marker for ovarian cancer diagnosis. It may be particularly useful when combined with CA-125 detection to reduce the number of false-positive results.

Risk of Epithelial Ovarian Cancer Recurrence in Patients With Rising Serum CA-125 Levels Within the Normal Range

2005 ◽  
Vol 23 (36) ◽  
pp. 9338-9343 ◽  
Author(s):  
Antonio Santillan ◽  
Ruchi Garg ◽  
Marianna L. Zahurak ◽  
Ginger J. Gardner ◽  
Robert L. Giuntoli ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Elevated Serum ◽  
Complete Response ◽  
Disease Recurrence ◽  
Ca 125 ◽  
Cancer Antigen 125 ◽  
Normal Range ◽  
Absolute Increase

PurposeTo evaluate the risk of epithelial ovarian cancer (EOC) recurrence in patients with rising serum cancer antigen 125 (CA-125) levels that remain below the upper limit of normal (< 35 U/mL).Patients and MethodsAll patients treated for EOC between September 1997 and March 2003 were identified and screened retrospectively for the following: (1) elevated serum CA-125 at time of diagnosis, (2) complete clinical and radiographic response (CR) to initial treatment with normalization of serum CA-125, (3) at least three serial serum CA-125 determinations that remained within the normal range, and (4) clinical and/or radiographic determination of disease status at the time of last follow-up or recurrence. For statistical analyses, univariate regression models were used to compare absolute and relative changes in CA-125 levels among patients with recurrent disease and those without EOC recurrence.ResultsA total of 39 patients satisfied study inclusion criteria; 22 patients manifested EOC recurrence at a median interval from complete response of 11 months. The median follow-up time from complete response to last contact was 32 months for the 17 patients in the no recurrence group. A relative increase in CA-125 of 100% (odds ratio [OR] = 23.7; 95% CI, 2.9 to 192.5; P = .003) was significantly predictive of recurrence. From baseline CA-125 nadir levels, an absolute increase in CA-125 of 5 U/mL (OR = 8.4; 95% CI, 2.2 to 32.6; P = .002) and 10 U/mL (OR = 71.2; 95% CI, 4.8 to > 999.9; P = .002) were also significantly associated with the likelihood of concurrent disease recurrence.ConclusionAmong patients with EOC in complete clinical remission, a progressive low-level increase in serum CA-125 levels is strongly predictive of disease recurrence.

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