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Federación Mexicana de Ginecología y Obstetricia, A.C.

2017, Number 12

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Ginecol Obstet Mex 2017; 85 (12)

Endometrioma with an unusual CA-19.9 elevation. A case report

Pérez-Ramírez NP, López-Rioja MJ, Delgado-Amador DE, Soriano-Jiménez JD, Recio-López Y, Medina-Jiménez V, Aguayo-González P

Language: Spanish
References: 41
Page: 839-845
PDF size: 496.04 Kb.


ABSTRACT

Background: Endometriosis is the presence of ectopic nonneoplastic endometrial tissue. The gold standard diagnosis is a visual hoinspection by laparoscopy. A CA-125 ›35 IU/mL and a CA-19.9 ›37 IU/mL have been present in endometriosis and ovarian tumors (teratomas, endometriomas or mucinous). However, an elevation ›300 IU/mL have a positive predictive value ›90% for pancreatic cancer.
Case Report: 32-year-old female, with 10-year primary infertility. With a complex tumor in the right ovary of 209cc and in the left one of 14.81cc. The CA-19.9 was at 2,920 IU/mL and the CA-125 at 142.37 IU/mL. In which have ruled out gastrointestinal malignancy with tomography and panendoscopy. A laparotomy exploratory was performed, finding a tumor of 10x8.0cm in the right ovary and 3.0x2.0cm in the left one. The pathology report was of endometriosis cysts, with no coexisting malignancy. At follow-up at 40 days a CA-19.9 of 41.38 IU/mL was found and at 60 days achieved a spontaneous pregnancy.
Conclusions: Tumor biomarkers are generally used to rule out malignant ovary pathology. There is insufficient evidence to recommend its routine use to diagnose endometriosis. However, when they are unusually above the cut-off point, it is important to specifically rule out gastrointestinal malignancy, working in a multidisciplinary way.


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