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Case Reports
. 2025 Jul 2;30(17):103866.
doi: 10.1016/j.jaccas.2025.103866.

Carbohydrate Antigen-125: Endometrial Cancer or Heart Failure Biomarker?

Vijay U Rao  1 , Thomas Fretz  2 , Tina Ayeni  3 , Kerry Skurka  4 , Meghana Raghavendra  5 , Ankur Kalra  6
Affiliations
Case Reports

Carbohydrate Antigen-125: Endometrial Cancer or Heart Failure Biomarker?

Vijay U Rao et al. JACC Case Rep. .

Abstract

Background: Carbohydrate antigen-125 (also known as cancer antigen-125) (CA-125) is a biomarker used to monitor for endometrial cancer progression, but it may also reflect other disease processes.

Case summary: A 70-year-old woman with metastatic endometrial cancer who was treated with paclitaxel, carboplatin, and pembrolizumab presented with new onset ascites and rising CA-125 levels concerning for cancer progression. She received a diagnosis of heart failure (HF) and normalized her CA-125 levels with loop diuretic agents without changing her oncologic treatment.

Discussion: CA-125 is a novel biomarker for HF monitoring because it correlates with increased intracardiac filling pressures. In this patient, concomitant endometrial malignant disease and HF complicated ascertainment of ascites and elevated biomarker origin. Therefore, clinicians should consider alternate causes of elevated CA-125 levels besides cancer progression.

Take-home message: CA-125 levels in patients with endometrial cancer may not always reflect cancer disease progression because levels can be influenced by the presence of HF.

Keywords: biomarker; carbohydrate antigen-125; diuresis; heart failure.

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Conflict of interest statement

Funding Support and Author Disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
Transthoracic Echocardiography (A) A 2-dimensional apical 4-chamber view demonstrating severe right ventricular enlargement with severe tricuspid valve regurgitation by color Doppler. (B) A 2-dimensional apical 4-chamber view demonstrating tricuspid valve morphology with malcoaptation of tricuspid valve leaflets resulting from right ventricular annular dilation. LV = left ventricle; RA = right atrium; RV = right ventricle; TV = tricuspid valve.
Figure 2
Figure 2
CA-125 Temporal Trends Carbohydrate antigen-125 (CA-125) levels returned to normal levels (<30 U/mL) after initiation of the loop diuretic agent torsemide (T) with no change in cancer therapy. P = paracentesis.
See this image and copyright information in PMC

References

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