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 Very High CA125 due to Non-neoplastic Lesion of Ovary

2014 ◽  
Vol 7 (2) ◽  
pp. 52-54
Author(s):  
KDB Bista
Keyword(s):  
Tumor Marker ◽  
Pelvic Inflammatory Disease ◽  
Young Woman ◽  
Inflammatory Disease ◽  
Abdominal Tuberculosis ◽  
Ca 125 ◽  
Ovarian Malignancy ◽  
Obstetrics And Gynaecology ◽  
Neoplastic Lesion ◽  
Very High

High CA-125 levels have been strongly associated with ovarian malignancy. But due to nonspecific nature of this tumor marker it has been found to be raised to high levels above 1000u/Ml even in some non neoplastic conditions which have to be kept in mind. A young woman was found to have very high Ca125 levels of 3500u/Ml after rupture of endometrioma. Endometrioma, pelvic inflammatory disease, abdominal tuberculosis are some of the nonneoplastic conditions associated with very high levels of Ca125. DOI: http://www.dx.doi.org/10.3126/njog.v7i2.11146   Nepal Journal of Obstetrics and Gynaecology / Vol 7 / No. 2 / Issue 14 / July-Dec, 2012 / 52-54

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.

scholarly journals Intra-abdominal tuberculosis masquerading as ovarian carcinoma

2019 ◽  
Vol 2019 (12) ◽  
Author(s):  
Yaying Eileen Xu ◽  
Kimberley Tan ◽  
Rasika Hendahewa
Keyword(s):  
Granulomatous Inflammation ◽  
Abdominal Tuberculosis ◽  
The Philippines ◽  
Ca 125 ◽  
Ovarian Malignancy ◽  
Cancer Antigen ◽  
Delay In Diagnosis ◽  
Menopausal Women ◽  
Standard Mode ◽  
Symptoms And Signs

Abstract Intra-abdominal tuberculosis (TB) is rare in Australia, but it can be found in those who emigrate from endemic areas. We report a rare case of a 28-year-old lady from the Philippines who presented with abdominal pain, ascites and an elevated cancer antigen (CA) 125 with an initial concern of ovarian malignancy. She underwent a diagnostic laparoscopy which revealed typical features of intra-abdominal TB and histological features of granulomatous inflammation. The symptoms and signs of intra-abdominal TB are non-specific and can mimic many other conditions. The gold-standard mode of diagnosis in intra-abdominal TB is laparoscopy with tissue biopsy. Ovarian malignancy is relatively rare in pre-menopausal women; hence an elevated CA 125 warrants a broader differential diagnosis. It is important to have intra-abdominal TB as a differential even in the non-endemic settings to avoid delay in diagnosis and appropriate management.

scholarly journals Endometrioma mimicking ovarian malignancy in a post-menopausal woman

2021 ◽  
Vol 10 (8) ◽  
pp. 3226
Author(s):  
Vijay Zutshi ◽  
Shreshtha Gupta ◽  
Charanjeet Ahluwalia ◽  
Monica R.
Keyword(s):  
Normal Serum ◽  
Reproductive Age ◽  
Ca 125 ◽  
Menopausal Woman ◽  
Ovarian Malignancy ◽  
Ovarian Endometriosis ◽  
Post Menopausal Woman ◽  
Estrogen Production ◽  
Malignant Ovarian Tumor ◽  
Post Menopausal

Endometriosis is an estrogen dependant disorder of reproductive-age women. It is uncommon after menopause, however, peripheral estrogen production may account for endometriosis in post-menopausal women. We reported a case of a 68 year old post-menopausal woman with an adnexal mass suspected malignant ovarian tumor on imaging and normal serum CA 125 levels. Total hysterectomy with bilateral salpingo-oophorectomy was done. The final histopathology revealed the diagnosis of ovarian endometriosis. Rarely, ovarian endometrioma can mimic ovarian malignancy in a post-menopausal woman.

scholarly journals Evaluation of HE4, CA-125, Risk of Ovarian Malignancy Algorithm (ROMA) and Risk of Malignancy Index (RMI) in the Preoperative Assessment of Patients with Adnexal Mass

2016 ◽  
Vol 31 (5) ◽  
pp. 336-344 ◽  
Author(s):  
Khawla Al Musalhi ◽  
Manal Al Kindi ◽  
Faiza Al Aisary ◽  
Fatma Ramadhan ◽  
Thuraya Al Rawahi ◽  
...  
Keyword(s):  
Adnexal Mass ◽  
Preoperative Assessment ◽  
Ca 125 ◽  
Ovarian Malignancy ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index

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 Abdominal tuberculosis with a Pseudo-Sister Mary Joseph nodule mimicking peritoneal carcinomatosis

2019 ◽  
Vol 12 (6) ◽  
pp. e229624 ◽  
Author(s):  
Amine Awad ◽  
Tom Pampiglione ◽  
Zaker Ullah
Keyword(s):  
Transvaginal Ultrasound ◽  
Positive Culture ◽  
Ct Scanning ◽  
Abdominal Tuberculosis ◽  
Tumour Marker ◽  
Interferon Γ ◽  
Ca 125 ◽  
Fluid Analysis ◽  
Release Assay ◽  
Sister Mary Joseph

A 46-year-old woman presented in severe abdominal pain on a background of 3 months of weight loss and intermittent vomiting. She had visited East Africa 6 months prior but reported no unwell contacts. On examination, she had generalised abdominal tenderness, distension and a painful paraumbilical swelling. CT scanning confirmed small bowel obstruction and revealed widespread peritoneal nodules, lymphadenopathy, ascites and a soft tissue paraumbilical mass. CA-125 tumour marker was elevated. However, transvaginal ultrasound scanning showed normal-appearing ovaries. She underwent a diagnostic laparoscopy for ascitic fluid analysis and biopsy of omental and peritoneal nodules, which revealed a lymphocytic exudate and caseating granulomas, respectively. Interferon-γ release assay and repeated stains for acid-fast bacilli were negative. She was commenced on antituberculous chemotherapy for a presumed diagnosis of abdominal tuberculosis. Positive culture results 2 weeks later confirmed Mycobacterium tuberculosis infection. The patient experienced a complete resolution of symptoms within 6 weeks of treatment.

scholarly journals Borderline Ovarian Tumors: Fifteen Years’ Experience at a Scottish Tertiary Cancer Center

2018 ◽  
Vol 28 (9) ◽  
pp. 1683-1691 ◽  
Author(s):  
James May ◽  
Karolina Skorupskaite ◽  
Mario Congiu ◽  
Nidal Ghaoui ◽  
Graeme A. Walker ◽  
...  
Keyword(s):  
Malignant Transformation ◽  
Surgical Management ◽  
Early Stage ◽  
Ovarian Tumors ◽  
Ca 125 ◽  
Ovarian Malignancy ◽  
Borderline Ovarian Tumors ◽  
Gynecology And Obstetrics ◽  
Preoperative Serum

ObjectivesSince the recognition of borderline ovarian tumors (BOTs) in the 1970s, the management of this subset of epithelial ovarian tumors has presented a challenge to clinicians. The majority present at an early stage, but their diagnosis is often only made following surgery, hence the heterogeneity of surgical management. Borderline ovarian tumors are morphologically diverse, and their behavior is subsequently also heterogeneous. We aimed to assess recurrence rates and the rate of malignant transformation in patients diagnosed with BOT. Secondary objectives included a review of current management and assessment of tumor markers, stage, cyst dimensions, and the presence of micropapillary features as prognostic indicators of recurrence.MethodsThis retrospective cohort study included all patients treated with BOT between 2000 and 2015 in the southeast region of Scotland. Clinical, surgicopathological, and follow-up data were collated. Data were analyzed with reference to recurrence and malignant transformation.ResultsTwo hundred seventy-five patients underwent treatment for BOT in the study period. Surgical management was highly variable. A diagnosis of recurrent/persistent BOT or ovarian malignancy following initial treatment of BOT was rare, with only 12 (4%) of 275 cases. There were 7 cases (3%) of ovarian malignancy. Advanced International Federation of Gynecology and Obstetrics stage was the most prominent prognostic factor. Elevated preoperative serum CA-125 and the presence of micropapillary features correlated with advanced stage at presentation. With a lack of clear guidance, follow-up was highly variable with a median of 43 months (0–136 months).ConclusionsTo our knowledge, this study is the largest BOT cohort in the United Kingdom. Recurrent disease is rare in optimally staged, completely resected, early-stage BOT, without high-risk features. Caution is needed in women electing not to undergo completion staging after diagnosis and in those opting for a fertility-preserving approach. Thorough informed consent and clear plans for surveillance and follow-up are needed with consideration of delayed completion surgery as appropriate.

scholarly journals Leiomyoma of Broad Ligament Mimicking Ovarian Malignancy– Report of a Unique Case

2015 ◽  
Vol 12 (3) ◽  
pp. 219-221
Author(s):  
D Mallick ◽  
M Saha ◽  
S Chakrabarti ◽  
J Chakraborty
Keyword(s):  
Histopathological Examination ◽  
Broad Ligament ◽  
Cystic Mass ◽  
Reproductive Age ◽  
Ca 125 ◽  
Resected Specimen ◽  
Benign Tumors ◽  
Ovarian Malignancy ◽  
Unique Case ◽  
The Right

Tumors of the broad ligament are uncommon. Leiomyoma, which is the commonest female genital neoplasm, is also the most common solid tumor of the broad ligament. Leiomyomas affect 30% of all women of reproductive age but the incidence of broad-ligament leiomyoma is <1%. These benign tumors are usually asymptomatic. A case is being described where a 52 year old presented with gradual abdominal swelling which was clinically and radiologically diagnosed as ovarian malignancy. On abdominal and bimanual palpation a soft cystic mass was noted in the right pelvic region. CA 125 was mildly raised. CEA, CA 19.9 levels were within normal limit. The radiological diagnosis was ovarian cyst with possibility of malignant changes. Staging laparotomy and histopathological examination of the resected specimen revealed a right sided broad ligament leiomyoma with cystic changes. The degenerative changes in the leiomyoma lead to the clinical and radiological diagnostic confusion. Thus, though uncommon, broad ligament leiomyoma should be considered during evaluation of adnexal masses for optimal patient management. The above description of leiomyoma in the broad ligament is a highly unique case and thus deserves appropriate attention.Kathmandu University Medical Journal Vol.12(3) 2014; 219-221

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