Impact of Serum CA19-9 Level in Clinico- Pathological and Radiologic Feature of Mature Cystic Teratoma: A Case Series

Ghasemian Dizajmehr, Sedigheh; Mohammadi Irvanlou, Mahsa; Mohammadi, Afshin; Rashidi Fakari, Farzaneh

doi:10.30699/jogcr.8.3.295

Document Type : Case Report Article

Authors

¹ Department of Obstetrics and Gynecology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran

² Department of Pathology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran

³ Department of Radiology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran

⁴ Department of Midwifery, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran

https://doi.org/10.30699/jogcr.8.3.295

Abstract

Background & Objective: Ovarian mature cystic teratomas (OMCTS) are one of the most common benign ovarian tumors. Most MCTs can be diagnosed by ultrasonography (us). Due to heterogeneous composition and a variety of appearance, in some non-diagnostic imaging reports it is suggested that we evaluate some tumor markers (CA125 and CA19-9) to complement imaging modalities. According to previous investigation, a single elevated CA 19-9 is in association with specific radio-pathologic features, such as size, torsion, bronchial glands, fat and teeth components. Here we are presenting three different cases of OMCT with different characteristics.
Case Presentation: Case 1: asymptomatic, non-diagnostic US, single- elevated CA19-9, smaller than in 10 cm with bronchial glands and fat component. Case 2: symptomatic, non-diagnostic U.S. normal CA19-9, larger than 10 cm with torsion and necrosis. Case 3: symptomatic, diagnostic US, single- elevated CA19-9, smaller than 10 cm, full of hair and sebaceous material. Computer tomography (CT), in all of our cases was diagnostic based on OMCT. Apologia of pathologic pathway of elevated CA19-9 in both cases 1 and 3 were in agreement with the result of previous investigations. In case 2, despite its large size and torsion, CA 19-9 level was low.
Conclusion: Single- elevated CA 19-9 level in OMCTs could impact benign characteristics of this kind of tumor.

Highlights

✅ Single- elevated CA 19-9 level in OMCTs could impact benign characteristics of this kind of tumor.

Keywords

Main Subjects

Gynecology Oncology

References

1. Huettner P. Diagnostic Gynecologic and Obstetric Pathology: LWW; 2007. [DOI:10.1097/01.pgp.0000235066.38925.1c]

2. Gunderson CC, Mannel RS, Di Saia PJ. Adnexal Masses. Clin Gynecol Oncol. 2017:231. [DOI:10.1016/B978-0-323-40067-1.00010-3] [PMID]

3. Sampaio J, Sarmento-Gonçalves I, Barros JM, Felix J, Tiago-Silva P. Mature Cystic Teratoma of Ovary with Abnormally High Levels of Ca19-9: A Case Report. Rev Bras de Ginecol e Obstet. 2016;38:365-7. [DOI:10.1055/s-0036-1586161] [PMID]

4. Benjapibal M, Boriboonhirunsarn D, Suphanit I, Sangkarat S. Benign cystic teratoma of the ovary: a review of 608 patients. J Med Assoc Thail= Chotmaihet thangphaet. 2000;83(9):1016-20.

5. Outwater EK, Siegelman ES, Hunt JL. Ovarian teratomas: tumor types and imaging characteristics. Radiographics. 2001;21(2):475-90. [DOI:10.1148/radiographics.21.2.g01mr09475] [PMID]

6. Emin U, Tayfun G, Cantekin I, Ozlem UB, Umit B, Leyla M. Tumor markers in mature cystic teratomas of the ovary. Arch Gynecol Obstet. 2009;279(2):145-7. [DOI:10.1007/s00404-008-0688-2] [PMID]

7. Guerriero S, Mallarini G, Ajossa S, Risalvato A, Satta R, Mais V, et al. Transvaginal ultrasound and computed tomography combined with clinical parameters and CA-125 determinations in the differential diagnosis of persistent ovarian cysts in premenopausal women. Ultrasound Obstet Gynecol. 1997;9(5):339-43. [DOI:10.1046/j.1469-0705.1997.09050339.x] [PMID]

8. Prodromidou A, Pandraklakis A, Loutradis D, Haidopoulos D. Is there a role of elevated CA 19-9 levels in the evaluation of clinical characteristics of mature cystic ovarian teratomas? A systematic review and meta-analysis. Cureus. 2019;11(12). [DOI:10.7759/cureus.6342] [PMID] [PMCID]

9. Suh DS, Moon SH, Kim SC, Joo JK, Park WY, Kim KH. Significant simultaneous changes in serum CA19-9 and CA125 due to prolonged torsion of mature cystic teratoma of the ovary. World J Surg Oncol. 2014;12(1):1-4. [DOI:10.1186/1477-7819-12-353] [PMID] [PMCID]

10. Cho HY, Kim K, Jeon YT, Kim YB, No JH. CA19-9 elevation in ovarian mature cystic teratoma: discrimination from ovarian cancer - CA19-9 level in teratoma. Med Sci Monit. 2013;19:230-5. [DOI:10.12659/MSM.883865] [PMID] [PMCID]

11. Cengiz H, Yasar L, Kaya C, Erkin M, Karakaş S. The role of tumor markers in predicting mature cystic teratoma of the ovary. Gineco. eu; 2012. p. 158-61.

12. Kyung MS, Choi JS, Hong SH, Kim HS. Elevated CA 19-9 levels in mature cystic teratoma of the ovary. Int J Biol Markers. 2009;24(1):52-6. [DOI:10.1177/172460080902400108] [DOI:10.5301/JBM.2009.3363] [PMID] [PMCID]

13. Artunc Ulkumen B, Goker A, Pala HG, Ordu S. Abnormal Elevated CA 19-9 in the Dermoid Cyst: A Sign of the Ovarian Torsion? Curr Obstet Gynecol. 2013;2013:860505. [DOI:10.1155/2013/860505] [PMID] [PMCID]

14. Kikkawa F, Ishikawa H, Tamakoshi K, Nawa A, Suganuma N, Tomoda Y. Squamous cell carcinoma arising from mature cystic teratoma of the ovary: A clinicopathologic analysis. Obstet Gynecol. 1997;89(6):1017-22. [DOI:10.1016/S0029-7844(97)00117-8] [PMID]

Journal of Obstetrics, Gynecology and Cancer Research

Impact of Serum CA19-9 Level in Clinico- Pathological and Radiologic Feature of Mature Cystic Teratoma: A Case Series

References

References

Volume 8, Issue 3 - Serial Number 32
May and June 2023
Pages 295-300

Impact of Serum CA19-9 Level in Clinico- Pathological and Radiologic Feature of Mature Cystic Teratoma: A Case Series

References

References

Volume 8, Issue 3 - Serial Number 32May and June 2023Pages 295-300

Volume 8, Issue 3 - Serial Number 32
May and June 2023
Pages 295-300