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Abstract
Introduction/Background Mature cystic teratoma (MCT) is one of the most common benign neoplasms, accounting for 10–20% of all ovarian tumors. Several studies showed CA19-9 -associated with gastrointestinal adenocarcinomas, has been suggested as a potential marker in prediction of ovarian MCT. The relationship between CA19-9 elevation and clinical characteristics of MCT has not been well established.
Methodology To the extent of our database search, we describe a case of MCT with the highest level of the serum Ca19-9 described in literature.
Results 51 year old women presented with chronic abdominal pain to our clinic, a pelvic examination and transvaginal ultrasound revealed a 78 × 59 mm multiloculated complex mass with echogenic areas arising from the left adnexa. The ovary was not visualised seperately from the mass. Abdominal examination was normal. Pre-operative CA-125 level was 23 U/ml (range 0–35 U/ml) and CA 19-9 level was 76.810 (range 0–35 U/ml) respectively.
Salphingooopherectomy with midline laparotomy was planned. ?ntraoperatively a 10 cm torsioned adnexial mass was visualied. Oopherectomy specimen was sent to frozen section which revealed a mature cycstic teratoma. Extensive histologic sectioning confirmed the diagnosis. The patient's postoperative period was uncomplicated and Ca19-9 sample retained two days postoperatively was 39.882 U/ml.
Conclusion Several retrospective studies mentioned CA 19-9 elevation appears to correlate with a larger tumor diameter and higher rate of ovarian torsion which corraletes with our case. Another retrospective study evaluating 215 patients with ovarian MCT concluded that serum CA19-9 levels were correlated with larger tumor size, although they failed to show a positive relationship between bilaterality and CA19-9 elevation.CA19-9 elevation was also correlated with the presence of fat component in the tumor at gross pathology findings. Unfortunately since the specimen was disected in frozen section and the cyst has a large sebum component we were not able to figure fat ratio.
Disclosure Nothing to disclose.
Intraoperative image of the mass