High Level of CA 125 Due to Large Endometrioma
Vorapong Phupong MD*, Orawan Chen MD*, Pornthip Ultchaswadi MD**
Affiliation : * Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University ** Department of Anesthesiology, Faculty of Medicine, Chulalongkorn University
Background : CA 125 is a tumor-associated antigen. Its high levels are usually associated with ovarian
malignancies, whereas smaller increases in the levels were associated with benign gynecologic conditions.
The authors report a high level of CA 125 in a case of large ovarian endometrioma.
Case Report : A 45-year-old nulliparous Thai woman, presented with an increase of her abdominal girth for
7 months. Transabdominal ultrasonogram demonstrated a large ovarian cyst and multiple small leiomyoma
uteri, and serum CA 125 level was 1,006 U/ml. The preoperative diagnosis was ovarian cancer with leiomyoma
uteri. Exploratory laparotomy was performed. There were a large right ovarian endometrioma, small left
ovarian endometrioma and multiple small leiomyoma. Total abdominal hysterectomy and bilateral salpingo-
oophorectomy was performed and histopathology confirmed the diagnosis of endometrioma and leiomyoma.
The serum CA 125 level declined to non-detectable at the 4th week. She was well at discharge and throughout
her 4th week follow-up period.
Conclusion : Although a very high level of CA 125 is associated with a malignant process, it can also be
found in benign conditions such as a large endometrioma. The case emphasizes the association of high levels
of CA 125 with benign gynecologic conditions.
Keywords : CA 125, Benign, Ovary, Endometrioma
