Correlation between tumor marker expression and tumor diameter in mature cystic teratoma of the ovary

Objective: We investigated the correlation between tumor diameter and the expression of tumor markers in ovarian mature cystic teratoma (MCT). Methods: Thirty-two patients with MCT who were surgically treated at our hospital between January 2013 and March 2015 were included in this study. We investigated the correlation between tumor diameter and tumor marker expression (squamous cell carcinoma antigen [SCC], carcinoembryonic antigen [CEA], carbohydrate antigen [CA]125, and CA19-9). Results: The median tumor diameter was 7.8 cm (range 5.0-16.0 cm). The median values of SCC, CEA, CA125, and CA19-9 were 1.25 ng/mL (range 0.6-3.5 ng/mL), 1.4 ng/mL (range 0.5-10.9 ng/mL), 16 U/mL (range 5.0-86.1 U/mL), and 34.6 U/mL (range 2.0-949.4 U/mL), respectively. The levels of SCC and CEA showed significant positive correlations with tumor diameter (respective correlation coefficients = 0.499 and 0.460), while the levels of CA19-9 and CA125 showed no significant correlation with the tumor diameter. We also encountered an example of malignant transformation of MCT during the study period. The tumor diameter in this case was 18.8 cm, and the preoperative level of SCC was 25 ng/mL, which is remarkably high, even considering the tumor diameter. Conclusion: In this study, the levels of SCC and CEA showed significant positive correlations with tumor diameter. High preoperative SCC and CEA levels may suggest that the tumor diameter should be considered when planning laparoscopic surgery. On the other hand, in cases in which the tumor markers are remarkably high, preoperative evaluation for the possibility of malignancy may be necessary.