n. a *tumour marker that can be detected by a simple blood test and is particularly useful in the diagnosis of ovarian cancer and also for subsequently monitoring its response to treatment. In a patient being evaluated for a pelvic mass, a CA125 level greater than 65 is associated with malignancy in approximately 90% of cases (see risk of malignancy index). A number of benign conditions, including endometriosis and heart failure, can also cause elevations of the CA125 level, as can cancers other than ovarian cancer, including malignancies of the endometrium, lung, breast, and gastrointestinal tract.
CA19-9 n. a substance whose presence in the bloodstream can be increased in certain cancers, such as pancreatic cancers, and is increasingly used as a *tumour marker in blood tests.
n. a complex *ovarian cyst, usually with ‘chocolate’ material (altered blood) inside and associated with *endometriosis. A history of cyclical enlargement of the nodule and painful periods is highly suggestive. There is a characteristic ground-glass appearance on transvaginal ultrasound and these cysts may be associated with a raised *CA125 level. Endometriomas are not amenable to medical therapy and should be surgically excised.... endometrioma
a malignant tumour of the ovary, usually a carcinoma. Because of its wide-ranging pathology and an imperfect understanding of its causes, ovarian cancer is not readily detected in the early stages of development, when the tumour is small and produces few suspicious symptoms. Increased susceptibility to the disease is associated with raised serum levels of *CA125 (see also risk of malignancy index; BRCA1 and BRCA2). Diagnosis is based on the finding of a solid or cystic mass arising from the pelvis; there may be associated *ascites. The incidence of ovarian cancer reaches a peak in postmenopausal women; treatment involves surgery and most cases also require combined chemotherapy and/or radiotherapy.... ovarian cancer
a benign tumour of the ovary, of which there are many varieties. The most common is a follicular cyst, resulting from growth of a *Graafian follicle that fails to ovulate or from involution of a mature follicle. It may rupture, causing pain. A luteal cyst occurs after an egg has been released from a follicle, which then becomes a *corpus luteum; instead of breaking down if a pregnancy does not occur, it fills with blood or fluid. Two-thirds of luteal cysts involve the right ovary and rupture occurs most commonly between days 20 and 28. The symptoms are not severe and settle spontaneously. Although most ovarian cysts are not malignant, they may reach a very large size, causing gross swelling of the abdomen and pressure on surrounding organs. The cyst may rotate on its stalk, thus cutting off its blood supply and causing severe abdominal pain and vomiting (ovarian torsion). In this case the cyst requires urgent surgical removal. Ovarian cysts that do become malignant may not be recognized until the tumour has advanced to a stage where treatment may be unsuccessful in eradicating the cancer. Screening programmes, based on ultrasound techniques, and *CA125 estimation, have been introduced in some areas to assist with the early detection of ovarian cysts and tumours.... ovarian cyst
(RMI) a scoring system that combines ultrasound findings, menopausal status and age, and serum CA125 levels to give an estimate of the risk of malignancy in a woman with a mass in the Fallopian tubes or ovaries. If the total RMI score is <200 the risk of malignancy is considered to be low. If the total RMI score is >200 the chances of malignancy are raised and management should be planned with a gynaecological oncologist.... risk of malignancy index
a substance produced by a tumour that can be used to aid detection of the tumour and to monitor its size and the effects of treatment. An example is *alpha-fetoprotein, which is used to monitor treatment of malignant *teratomas. See also CA125; CA19-9; carcino-embryonic antigen; human chorionic gonadotrophin.... tumour marker
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