Extremely elevated serum CA-125 level as a result of unruptured unilateral endometrioma: the highest value reported.

OBJECTIVE

To present a case of a unilateral endometrioma with extremely elevated serum CA-125 levels.

DESIGN

Case report.

SETTING

University hospital.

PATIENT(S): A 25-year-old woman with left adnexal mass and extremely elevated serum CA-125 level, 7,900 U/mL, underwent laparoscopy. There were unilateral endometrioma and stage IV endometriosis.

INTERVENTION(S): Laparoscopic excision of the endometrioma, unilateral salpingectomy, adhesiolysis, ablation of endometriotic foci, and partial omentectomy were performed, and histopathologic results confirmed the diagnosis of endometriosis.

MAIN OUTCOME MEASURE(S): Extremely elevated serum CA-125 levels and unruptured ovarian endometrioma.

RESULT(S): On the second, sixth, and 13th days of the menstrual period, serum CA-125 levels were 7,900 U/mL, 1,577 U/mL, and 627 U/mL, respectively. On the third postoperative day serum CA-125 level was 56 U/mL.

CONCLUSION(S): Ovarian endometrioma and advanced endometriosis may be associated with extremely elevated serum CA-125 levels. For this reason ovarian endometrioma should be considered with respect to differential diagnosis of reproductive-age women presenting with an ovarian mass even if it resembles an ovarian malignancy.