Publication:

Ovarian fibroma with elevated CA125 and OVA1 in postmenopausal woman

Ovarian fibroma is a sexcord stromal tumor, which accounts for 4% of all ovarian tumors. It is uncommon benign tumor of ovary. Clinically, it is asymptomatic and may typically be detected during routine gynecological examinations. It may be associated with ascitis and hydrothorax known as Meig's Syndrome. Usually these ovarian tumors are unilateral, solid, hard masses with small areas of cystic degeneration. Due to their solid structure, these benign tumors are sometimes confused with malignant ovarian neoplasm during clinical evaluation. A 59 year old postmenopausal woman presented with flank pain and new onset urinary incontinence. Ultrasound evaluation revealed a pelvic mass. Labs showed elevated tumor marker level. The patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy. Pathological examination however revealed an ovarian fibroma. During the postmenopausal years, the ovaries become atrophic. The incidence ovarian neoplasm increases with age. A suspicious or persistent complex mass and increased tumor marker like CA125 and OVA1 in post-menopausal woman requires surgical evaluation. The traditional diagnostic tools for ovarian tumors are bimanual examination, pelvic ultrasound and measuring serum biomarker like CA125 level, but these methods have low specificity and sensitivity. Now-a-days the role of some tumor marker such as OVA1in the management of ovarian tumor has been approved by FDA.