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Gulhane Med J. 2010; 52(1): 049-051

Ruptured endometrioma and high levels of tumor markers: a case report

İbrahim Alanbay, Emre Karaşahin, C.Mutlu Ercan, Ulaş Fidan, Murat Dede, Müfit C. Yenen.

CA 125 is a tumor-associated antigen. Its high levels are usually associated with ovarian malignancies, however increases in its levels may also be encountered in benign gynecologic conditions. Patients with endometriosis have rarely a serum CA 125 concentration exceeding 100 IU/ml. In this article a high level of CA 125 in a case of large ruptured ovarian endometrioma is reported. A 20-year-old nulligravida woman presented with an abdominal pain lasting for 8 hours. Transabdominal ultrasonography demonstrated bilaterally large endometriomas, and serum CA 125 and CA 19-9 levels were detected as 3434 U/ml and 1175 U/ml, respectively. Exploratory laparatomy was performed, and two endometrioma cysts with a diameter of 15 cm and 12 cm in the right and left overs, respectively, were excised. The diagnosis was confirmed histopathologically. The serum CA 125 and 19-9 levels tended to decrease in 8 weeks and declined to normal levels in 16 weeks. CA 125 and 19-9 are usually associated with a malignant process. However they may also increase in benign conditions such as a ruptured endometrioma. The case emphasizes that high levels of CA 125 and 19-9 may also be encountered in benign gynecologic conditions.

Key words: Endometrioma, rupture, tumor markers

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