Abstract
A case of a middle-aged African-American woman with weight loss, ascites, a bilateral pleural effusion with no infiltrate, and a clinical diagnosis of a metastatic gynecological tumor is presented. Her carcinoembryonic antigen (CEA) and CA-125 levels were elevated (400 micrograms/L and 331 micrograms/L, respectively). She underwent an exploratory laparotomy and a dilation & curettage for biopsies and cultures. Pathological examination showed Langhans' type giant cells on peritoneal biopsy. An endometrial curette biopsy showed granulomatous endometritis and acid-fast bacilli. Cultures grew Mycobacterium tuberculosis. The patient presented with a fibroid tumor that could have contributed to her elevated CA-125 level, but after antituberculous treatment was started and tumor markers were repeated after 1 year, the CEA level decreased to 1.2 micrograms/L and CA-125 to 9 micrograms/L without surgical resection of the tumor. A review of the literature revealed only three cases in which patients had elevated CA-125 in multivisceral tuberculosis. No cases were reported in which both CEA and CA-125 levels were elevated in multivisceral tuberculosis. Possible causes of elevated CEA and CA-125 levels are discussed.
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Selected References
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- Halila H., Lehtovirta P., Stenman U. H., Seppälä M. CA 125 in the follow-up of patients with ovarian cancer. Acta Obstet Gynecol Scand. 1988;67(1):53–58. doi: 10.3109/00016348809004168. [DOI] [PubMed] [Google Scholar]
- Halila H., Stenman U. H., Seppälä M. Ovarian cancer antigen CA 125 levels in pelvic inflammatory disease and pregnancy. Cancer. 1986 Apr 1;57(7):1327–1329. doi: 10.1002/1097-0142(19860401)57:7<1327::aid-cncr2820570713>3.0.co;2-z. [DOI] [PubMed] [Google Scholar]
- Klein M., Kaminsky P., Reichert S., Brun D., Aubert V., Duc M. Elévation du CA 125 dans une tuberculose multiviscérale sans épanchement séreux. Presse Med. 1991 May 25;20(20):959–960. [PubMed] [Google Scholar]
- Malkasian G. D., Jr, Podratz K. C., Stanhope C. R., Ritts R. E., Jr, Zurawski V. R., Jr CA 125 in gynecologic practice. Am J Obstet Gynecol. 1986 Sep;155(3):515–518. doi: 10.1016/0002-9378(86)90269-3. [DOI] [PubMed] [Google Scholar]
- O'Riordan D. K., Deery A., Dorman A., Epstein O. E. Increased CA 125 in a patient with tuberculous peritonitis: case report and review of published works. Gut. 1995 Feb;36(2):303–305. doi: 10.1136/gut.36.2.303. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ruibal A., Encabo G., Martinéz-Miralles E., Murcia C., Capdevila J. A., Salgado A., Martinéz-Vasquéz J. M. CA125 seric levels in non malignant pathologies. Bull Cancer. 1984;71(2):145–146. [PubMed] [Google Scholar]