Dept. Of Pathology, SBL Diagnostics, Mysore, India
Abstract
We report a case of florid polypoid endometriosis presenting with advanced bulky disease in pelvis with serum CA – 125 levels of 7844U/ml. The extent of tumor, CT scan findings, elevated serum CA – 125 levels were suggestive of ovarian malignancy. Histopathology demonstrated endometrial glands and stroma. Glands were neither crowded nor complex and were separated by a fibromatous stroma that contained endometrial stromal cells. These features were consistent with diagnosis of polypoid endometriosis, a recently described entity with a clinical presentation completely different from conventional endometriosis. Our case emphasizes the association of high levels of CA – 125 with benign gynaecologic conditions.
Shiau CS, Chang MY, Chiang CH, Hsieh CC, Hsieh TT. Ovarian endometrioma ssociated with very high serum CA-125 levels. Chang Gung Med J 2003;26(9):695-9.
Jacobs I, Bast RCJ. The CA 125 tumor-associated antigen: a review of the literature. Hum Reprod 1989;4:1-12.
Ho HN, Wu MY, Chen SU. Total antioxidant status and nitric oxide do not increase in peritoneal fluids from women with endometriosis. Hum Reprod 1997;1:2810-5.
Di-Xia C, Schwartz PE, Xinguo L, Zhan Y. Evaluation of CA 125 levels in differentiating malignant from benign tumors in patients with pelvic masses. Obstet Gynecol 1988;72:23-7.
Ghaemmaghami F, Karimi Zarchi M, Hamedi B. High levels of CA125 ( over 1,000IU/ml ) in patients with gynecologic disesase and no malignant conditions : three cases and literature review. Arch Gynecol Obstet 2007;276(5):559-61.
Gocmen A, Karaca M, Tarakcioglu M. A ruptured ovarian endometrioma mimicking ovarian malignancy: case report. Eur J Gynaecol Oncol 2003;24(5):445-6.
Kwek JW, H'ng MW, Chew SH, Tay EH. Florid polypoid endometriosis of the cervix with left ureteric obstruction: a mimic of cervical malignancy. Ultrasound Obstet Gynecol 2010;36(2):252-4.
Parker RL, Dadmanesh F, Young RH, Clement PB. Polypoid endometriosis: a clinicopathologic analysis of 24 cases and a review of the literature. Am J Surg Pathol 2004;28:285–97.
Laird LA, Hoffman JS, Omrani A Multifocal polypoid endometriosis presenting as huge pelvic masses causing deep vein thrombosis. Arch Pathol Lab Med 2004;128(5):561-4.
Kaushal S, Dadhwal V, Mathur SR, Ray R, Durgapal P, Deka D. Multifocal polypoid endometriosis in a young woman simulating vaginal and pelvic neoplasm. J Clin Pathol 2010;63(5):452-4
Mills SE. Sternberg’s Diagnostic Surgical Pathology. 4th ed. New York: Lippincott Williams and Wilkins; 2004.
Tolman CJ, Vaid T, Schreuder HW. Extremely elevated CA-125 in benign ovarian disease due to stretch of the peritoneum. BMJ Case Rep 2012;doi:10.1136/bcr-2012-006664.
Ghante Nagaraj,S. , Chalageri,A. , Gupta,A. and Vijayanand,M. (2014). Florid Adnexal Polypoid Endometriosis Associated with Very High Serum Ca - 125 Levels Mimicking Ovarian Malignancy. Iranian Journal of Pathology, 9(1), 71-76.
MLA
Ghante Nagaraj,S. , , Chalageri,A. , , Gupta,A. , and Vijayanand,M. . "Florid Adnexal Polypoid Endometriosis Associated with Very High Serum Ca - 125 Levels Mimicking Ovarian Malignancy", Iranian Journal of Pathology, 9, 1, 2014, 71-76.
HARVARD
Ghante Nagaraj S., Chalageri A., Gupta A., Vijayanand M. (2014). 'Florid Adnexal Polypoid Endometriosis Associated with Very High Serum Ca - 125 Levels Mimicking Ovarian Malignancy', Iranian Journal of Pathology, 9(1), pp. 71-76.
CHICAGO
S. Ghante Nagaraj, A. Chalageri, A. Gupta and M. Vijayanand, "Florid Adnexal Polypoid Endometriosis Associated with Very High Serum Ca - 125 Levels Mimicking Ovarian Malignancy," Iranian Journal of Pathology, 9 1 (2014): 71-76,
VANCOUVER
Ghante Nagaraj S., Chalageri A., Gupta A., Vijayanand M. Florid Adnexal Polypoid Endometriosis Associated with Very High Serum Ca - 125 Levels Mimicking Ovarian Malignancy. Iran J Pathol, 2014; 9(1): 71-76.