Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009:2009:bcr11.2008.1219.
doi: 10.1136/bcr.11.2008.1219. Epub 2009 Mar 20.

Markedly elevated CA19-9 associated with benign ovarian cyst and ascites

Oliver Brain  1 , Laura H W Brown, Shaila Suvarna, Roger Chapman
Affiliations

Markedly elevated CA19-9 associated with benign ovarian cyst and ascites

Oliver Brain et al. BMJ Case Rep. 2009.

Abstract

A 60-year-old woman presented after a fall and was noted to have ascites. She had a history of ulcerative colitis. History and physical examination did not reveal the likely aetiology of the ascites, but a sample showed it to be a blood-stained exudate. A malignant cause appeared likely, cross-sectional imaging was arranged and tumour markers sent. CA125 was 34 IU/ml (0-30); α-fetoprotein (AFP) and carcinoembryonic antigen (CEA) were normal. However, CA19-9 was 2880 U/ml (0-31). Pancreatic carcinoma or cholangiocarcinoma were of prime concern, but a CT scan and MRI imaging were normal. At laparoscopy a benign ruptured ovarian cyst was detected, and ascites drained. CA19-9 returned to normal and the patient remains well 9 months later. This case demonstrates how tumour markers may be misleading in the context of diagnostics, and is the highest reported example of CA19-9 rise in the context of benign ascites and benign ovarian pathology.

PubMed Disclaimer

Figures

Figure 1
Figure 1
A. Cyst wall biopsy; degenerate benign indeterminate cyst. B. CA125 immunostain. C. Carcinoembryonic antigen (CEA) immunostain. D. CA19-9 immunostain.
Figure 2
Figure 2
Tumour markers and C-reactive protein (CRP).
See this image and copyright information in PMC

References

    1. Koprowski H, Herlyn M, Steplewski Z, et al. Specific antigen in serum of patients with colon carcinoma. Science 1981; 212: 53–5 - PubMed
    1. Boeck S, Stieber P, Holdenrieder S, et al. Prognostic and therapeutic significance of carbohydrate antigen 19-9 as tumor marker in patients with pancreatic cancer. Oncology 2006; 70: 255–64 - PubMed
    1. Nanayakkara S, Ali S, Gilmour K. Increased serum carcinomic antigen 19-9 (CA 19-9) in a dermoid cyst. J Obst Gynaecol 2007; 27: 96–7 - PubMed
    1. Atabekoglu C, Bozac EA, Tezcan S. Elevated carbohydrate antigen 19-9 in a dermoid cyst. Int J Gynaecol Obstet 2005; 91: 262–3 - PubMed
    1. Nagata H, Takahashi K, Yamane Y, et al. Abnormally high values of CA 125 and CA 19-9 in women with benign tumors. Gynecol Obstet Invest 1989; 28: 165–8 - PubMed