Three cases of adnexal and peritoneal malignancies with high CA125 levels that took time to confirm the diagnosis

Abstract

Screening methods for ovarian, fallopian tube, and peritoneal cancer have not been established and there are sometimes difficulties in dealing with patients only with a high CA125 levels. In this report, we experienced two cases in which it took more than half a year from the time the patient visited a gynecologist because of a high CA125 level to the time the diagnosis of malignancy was confirmed. Case 1: 53 years old woman with a high CA125 level and her sister had ovarian cancer at the age of 45; was diagnosed as high grade serous carcinoma about six months after the first visit to our department. Case 2: 70 years old woman with a history of breast cancer and a high CA125 level was diagnosed as tubal high grade serous carcinoma one year later of the first visit. Genetic tests revealed they are BRCA2 pathological variant carriers. Although the significance of screening tests based on CA125 levels in the general population has not been established, a visit to a gynecologist because of an elevated CA125 level provides an opportunity to pick up high-risk patients for ovarian cancer by asking about medical and family history. 〔Adv Obstet Gynecol, 76(1): 38-44, 2024(R6.2)〕