2023 Volume 37 Issue 5 Pages 815-818
A highly elevated serum CA125 level (CA125) suggests the presence of ovarian carcinoma, primary peritoneal carcinoma (PPC), or advanced malignancy of the uterine body. On the other hand, rare cases of highly elevated CA125 have been reported in patients with benign uterine tumors, such as uterine fibroids and uterine adenomyosis (UA), as well as coexisting stage II PPC with a large uterine myoma.
A 50-year-old woman underwent molecular tumor marker screening and abdominal ultrasonography in a part of Ningen Dock. The examination revealed a highly elevated CA125 and an enlarged uterus measuring 8 cm in diameter that underwent a detailed examination using MRI. MRI revealed a diagnosis of UA; however, a laparoscopic total hysterectomy was performed to evaluate the patient for PPC and to detect an increase in the size of the uterus to over 8 cm despite postmenopausal age. Peritoneal cancer was ruled out, and CA125 recovered within standard values postoperatively.
In postmenopausal women with UA of 5 cm or more and highly elevated CA125, the option of less invasive total hysterectomy with specular observation of the adnexa, including the retroperitoneum, is acceptable with informed consent of the patient.
