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
Case Reports
. 2022 Jun 8;20(1):188.
doi: 10.1186/s12957-022-02651-w.

Tubo-ovarian mass with raised CA-125 in a 21-year-old female

Roli Purwar  1 , Kishan Soni  2 , Ragini Tilak  3 , Ashish Verma  4 , Manoj Pandey  5
Affiliations
Case Reports

Tubo-ovarian mass with raised CA-125 in a 21-year-old female

Roli Purwar et al. World J Surg Oncol. .

Abstract

Introduction: Peritonitis associated with fungal species Curvularia lunata seldom occurs with only five cases reported in the literature, all in middle-age patients with comorbidities undergoing dialysis.

Case report: A 21-year-old female who was referred to surgical oncology OPD with a diagnosis of ovarian malignancy, based on raised cancer antigen 125 (CA 125) and suspected tubo-ovarian mass (TOM) on magnetic resonance imaging (MRI). A review of the MRI showed a pelvic collection with TOM, suggestive of infective pathology. Fungal culture and mass spectroscopy of the cystic collection identified the presence of Curvularia lunata. She was treated with oral itraconazole which showed symptomatic improvement and radiological response. In the follow-up period, the patient developed chest wall swelling, aspiration and geneXpert® revealed multidrug-resistant (MDR) tuberculosis, and treatment was started.

Conclusions: Unusual causes of TOM and raised CA 125 should be kept in mind when dealing with young patients, as the possibility of epithelial ovarian cancer in this age is very low.

Keywords: Curvularia; Fungal; Infection; Peritonitis; Young.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Axial MRI images of the pelvis before treatment showing the uterus in the center with a multiloculated cystic lesion being hypoattenuating on the CT scan (A, B), variably hyperintense on T2-weighted MRI (C, D), and variably hyperintense to hypointense on T1-weighted (E, F) images. The lesion also shows calcification on the CT scan (black straight arrow in A) and variable intensity pattern (curved arrows) suggesting that there are cystic components of various compositions. The lesion also shows a partial septa sign (twisted arrow in C), and this along with close circumferential relation with ovaries (straight white arrows in all sections) clearly indicated towards a possible tubo-ovarian origin of the mass. The bulk of both ovaries is however visualized normally (straight white arrows)
Fig. 2
Fig. 2
Axial MRI images of the pelvis after treatment showing the uterus in the center with near-total resolution of previously seen mass. Only a small component which has verted to the left side (curved arrow) is remaining. The previously seen calcification is still noted (twisted arrow). The bulk of both ovaries is however visualized normally (straight white arrow). Mild ascites is seen (straight black arrow) which may indicate post-treatment residual peritumoral inflammation
Fig. 3
Fig. 3
Computerized tomography scan of the lung and thorax showing A axial section of bilateral lung showing disseminated tuberculosis lesions in both lungs, B sagittal section showing the parenchymal lesions, C axial section showing submammary plural collection, and D axial section showing subcutaneous collection (cold abscess) at 7 o’clock position
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Terada M, Ohki E, Yamagishi Y, et al. Fungal peritonitis associated with Curvularia geniculata and Pithomyces species in a patient with vulvar cancer who was successfully treated with oral voriconazole. J Antibiot. 2014;67:191–193. doi: 10.1038/ja.2013.108. - DOI - PubMed
    1. Rinaldi MG, Phillips P, Schwartz JG, Winn RE, Holt GR, Shagets FW, Elrod J, Nishioka G, Aufdemorte TB. Human Curvularia infections. Report of five cases and review of the literature. Diagn Microbiol Infect Dis. 1987;6(1):27–39. doi: 10.1016/0732-8893(87)90111-8. - DOI - PubMed
    1. Guarner J, et al. Fungal peritonitis caused by Curvularia lunata in a patient undergoing peritoneal dialysis. Am J Med Sci. 1989;298:320–323. doi: 10.1097/00000441-198911000-00008. - DOI - PubMed
    1. Ujhelyi MR, Raasch RH, van der Horst CM, Mattern WD. Treatment of peritonitis due to Curvularia and Trichosporon with amphotericin B. Rev Infect Dis. 1990;12(4):621–627. doi: 10.1093/clinids/12.4.621. - DOI - PubMed
    1. Lopes JO, et al. Curvularia lunata peritonitis complicating peritoneal dialysis. Mycopathologia. 1994;127:65–67. doi: 10.1007/BF01103059. - DOI - PubMed

Publication types

Supplementary concepts