Markedly elevated CA125 in hepatic cirrhosis two case - Two case illustrations and review of the literature

CA125 is the most widely used tumor marker presently available for use in p atients with epithelial ovarian cancer. Although elevated in a high percent age of patients with ovarian cancer, serum CA125 levels have also been dete cted in patients with numerous benign and malignant nongynecologic disorder s, including various diseases of the liver. Despite this well-publicized fa ct, it has become apparent that the association between CA125 elevation, pa rticularly the degree of elevation, and liver disease may not be as widely recognized as one would suspect. When marked CA125 elevations occur, diagno stic confusion is common. We describe two cases illustrative of this point. Both cases involve middle-aged women who presented with massive ascites an d due to markedly elevated serum CA125 levels underwent exploratory laparot omy with hysterectomy and/or bilateral salpingo-oopherectomy before their r eferral to our center. Because preservation of a woman's reproductive organ s is a significant concern, it is imperative that both primary care physici ans and specialists are aware of such associations and the proper use of tu mor markers.