HomeAnswersObstetrics and Gynecologyovarian cystsI have bloating and irregular periods. Is a biopsy required?

Does an elevated CA-125 always indicate a malignant condition of the ovaries?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Reetika

Medically reviewed by

iCliniq medical review team

Published At July 19, 2022
Reviewed AtOctober 9, 2023

Patient's Query

Hi doctor,

I have a history of ovarian cyst and partial right ovary removal nine years back. I took Sulfa drugs, tablet Toradol 25 mg and tablet Zofran. I have a history of pregnancy and breastfeeding twice. I have had a mass of 2 cm in my ovary for the past two years. It enlarged to 5.7 cm nine months back, and I was diagnosed with complex ovarian mass calcifications and septations. I had menstrual cramps, dizziness, vomiting, and fever two months back. My MRI report showed a 7.2 cm germ cell tumor. Due to unavoidable circumstances, I could not undergo surgeries these many years. I am going to have surgery this week. I have pain in the right and left ovaries, bloating, and awful periods. Should I take a biopsy? Is it a cancerous condition? I have attached the reports.

Answered by Dr. Reetika

Hi,

Welcome to icliniq.com.

From the reports attached (attachment removed to protect the patient's identity), it is referred to as a germ cell tumor when you were 25 years old. It is mentioned as a calcified growth, and if it is not outside the ovarian capsule, you will be fine after surgery. Provide details about tumor markers for diagnosis. Prognosis can be determined after examining the mass.

Patient's Query

Thank you doctor for the reply,

I had 28.1 units/mL of CA-125 before nine months. Will this level increase in malignant conditions?

Answered by Dr. Reetika

Hi,

Welcome back to icliniq.com.

In young adults, germ cell tumors are diagnosed with LDH (serum lactate dehydrogenase), hCG (human Chorionic Gonadotropin), and alpha-fetoprotein. Teratoma is diagnosed by CA 19-9 (carbohydrate antigen). CA 125 is used to diagnose epithelial tumors in older females.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Reetika
Dr. Reetika

Obstetrics and Gynecology

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