Premenarchal Ovarian Torsion and Elevated CA-125
Abstract Background Ovarian tumors are the most common gynecologic malignancy occurring in childhood, with germ cell tumors being most frequent. This contrasts with adults where epithelial tumors account for most ovarian neoplasms. Tumor markers are an integral part of the work-up and may guide mana...
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| Veröffentlicht in: | Journal of pediatric & adolescent gynecology 2010-02, Vol.23 (1), p.e47-e50 |
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| creator | McCarthy, Jenifer D., MD Erickson, Kimberly M., MD Smith, Yolanda R., MD Quint, Elisabeth H., MD |
| description | Abstract Background Ovarian tumors are the most common gynecologic malignancy occurring in childhood, with germ cell tumors being most frequent. This contrasts with adults where epithelial tumors account for most ovarian neoplasms. Tumor markers are an integral part of the work-up and may guide management. Case A 6-year-old girl with a persistent adnexal mass was found to have a highly elevated CA-125. Other tumor markers were normal. Laparoscopy revealed an enlarged, adherent ovary. A minilaparotomy revealed an ovary filled with necrotic material. This necrotic material was excised and the ovary was spared. The pathology was consistent with necrosis. Follow-up ultrasonography and CA-125 were normal. Summary and Conclusions This case demonstrates for the first time the association of an elevated CA-125 and ovarian torsion in a pediatric patient. This benign finding allowed attempting a conservative ovary-sparing approach during the surgery even in the presence of a highly elevated CA-125. However, in general, for children CA-125 is of limited utility, as it will not affect the indication for surgical exploration of persistent masses and elevations in CA-125 may discourage ovarian conservation. |
| doi_str_mv | 10.1016/j.jpag.2009.04.002 |
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This contrasts with adults where epithelial tumors account for most ovarian neoplasms. Tumor markers are an integral part of the work-up and may guide management. Case A 6-year-old girl with a persistent adnexal mass was found to have a highly elevated CA-125. Other tumor markers were normal. Laparoscopy revealed an enlarged, adherent ovary. A minilaparotomy revealed an ovary filled with necrotic material. This necrotic material was excised and the ovary was spared. The pathology was consistent with necrosis. Follow-up ultrasonography and CA-125 were normal. Summary and Conclusions This case demonstrates for the first time the association of an elevated CA-125 and ovarian torsion in a pediatric patient. This benign finding allowed attempting a conservative ovary-sparing approach during the surgery even in the presence of a highly elevated CA-125. However, in general, for children CA-125 is of limited utility, as it will not affect the indication for surgical exploration of persistent masses and elevations in CA-125 may discourage ovarian conservation.</description><identifier>ISSN: 1083-3188</identifier><identifier>EISSN: 1873-4332</identifier><identifier>DOI: 10.1016/j.jpag.2009.04.002</identifier><identifier>PMID: 19589703</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adnexal mass ; CA-125 Antigen - blood ; Child ; Children ; Female ; Humans ; Laparoscopy ; Necrosis - blood ; Necrosis - pathology ; Necrosis - surgery ; Obstetrics and Gynecology ; Ovarian Diseases - blood ; Ovarian Diseases - pathology ; Ovarian Diseases - surgery ; Pediatrics ; Torsion Abnormality - blood ; Torsion Abnormality - surgery ; Tumor marker</subject><ispartof>Journal of pediatric & adolescent gynecology, 2010-02, Vol.23 (1), p.e47-e50</ispartof><rights>North American Society for Pediatric and Adolescent Gynecology</rights><rights>2010 North American Society for Pediatric and Adolescent Gynecology</rights><rights>Copyright 2010 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.</rights><rights>2009 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved. 2009</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4242-345e5ac3e707faf5b613ed9f0785b59c37b00a590540c814add07038af8d11cc3</citedby><cites>FETCH-LOGICAL-c4242-345e5ac3e707faf5b613ed9f0785b59c37b00a590540c814add07038af8d11cc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jpag.2009.04.002$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,780,784,885,3548,27923,27924,45994</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19589703$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>McCarthy, Jenifer D., MD</creatorcontrib><creatorcontrib>Erickson, Kimberly M., MD</creatorcontrib><creatorcontrib>Smith, Yolanda R., MD</creatorcontrib><creatorcontrib>Quint, Elisabeth H., MD</creatorcontrib><title>Premenarchal Ovarian Torsion and Elevated CA-125</title><title>Journal of pediatric & adolescent gynecology</title><addtitle>J Pediatr Adolesc Gynecol</addtitle><description>Abstract Background Ovarian tumors are the most common gynecologic malignancy occurring in childhood, with germ cell tumors being most frequent. This contrasts with adults where epithelial tumors account for most ovarian neoplasms. Tumor markers are an integral part of the work-up and may guide management. Case A 6-year-old girl with a persistent adnexal mass was found to have a highly elevated CA-125. Other tumor markers were normal. Laparoscopy revealed an enlarged, adherent ovary. A minilaparotomy revealed an ovary filled with necrotic material. This necrotic material was excised and the ovary was spared. The pathology was consistent with necrosis. Follow-up ultrasonography and CA-125 were normal. Summary and Conclusions This case demonstrates for the first time the association of an elevated CA-125 and ovarian torsion in a pediatric patient. This benign finding allowed attempting a conservative ovary-sparing approach during the surgery even in the presence of a highly elevated CA-125. However, in general, for children CA-125 is of limited utility, as it will not affect the indication for surgical exploration of persistent masses and elevations in CA-125 may discourage ovarian conservation.</description><subject>Adnexal mass</subject><subject>CA-125 Antigen - blood</subject><subject>Child</subject><subject>Children</subject><subject>Female</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Necrosis - blood</subject><subject>Necrosis - pathology</subject><subject>Necrosis - surgery</subject><subject>Obstetrics and Gynecology</subject><subject>Ovarian Diseases - blood</subject><subject>Ovarian Diseases - pathology</subject><subject>Ovarian Diseases - surgery</subject><subject>Pediatrics</subject><subject>Torsion Abnormality - blood</subject><subject>Torsion Abnormality - surgery</subject><subject>Tumor marker</subject><issn>1083-3188</issn><issn>1873-4332</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUtr3DAURk1padK0f6CL4l1Xdq9eYxlKIAzpAwIpJFlfNNJ1ItcjTaWZgfz7yszQRxZZSaDvO7qcW1XvGbQM2OLT2I4bc99ygL4F2QLwF9Up051opBD8ZbmDFo1gWp9Ub3IeAaBTC_26OmG90n0H4rSCH4nWFEyyD2aqr_cmeRPq25iyj6E2wdWXE-3Nlly9vGgYV2-rV4OZMr07nmfV3ZfL2-W35ur66_flxVVjJZe8EVKRMlZQB91gBrVaMEGuH6DTaqV6K7oVgFE9KAlWM2mcgzKQNoN2jFkrzqrzA3ezW63JWQrbZCbcJL826RGj8fj_S_APeB_3yDXTIHkBfDwCUvy1o7zFtc-WpskEiruMXXGkoVesJPkhaVPMOdHw5xcGOJvGEWfTOJtGkFhMl9KHf-f7WzmqLYHPhwAVS3tPCbP1FCw5n8hu0UX_PP_8Sd1OPnhrpp_0SHmMuxSKf2SYOQLezLueVw09FKJW4jfUBKLV</recordid><startdate>201002</startdate><enddate>201002</enddate><creator>McCarthy, Jenifer D., MD</creator><creator>Erickson, Kimberly M., MD</creator><creator>Smith, Yolanda R., MD</creator><creator>Quint, Elisabeth H., MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201002</creationdate><title>Premenarchal Ovarian Torsion and Elevated CA-125</title><author>McCarthy, Jenifer D., MD ; Erickson, Kimberly M., MD ; Smith, Yolanda R., MD ; Quint, Elisabeth H., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4242-345e5ac3e707faf5b613ed9f0785b59c37b00a590540c814add07038af8d11cc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adnexal mass</topic><topic>CA-125 Antigen - blood</topic><topic>Child</topic><topic>Children</topic><topic>Female</topic><topic>Humans</topic><topic>Laparoscopy</topic><topic>Necrosis - blood</topic><topic>Necrosis - pathology</topic><topic>Necrosis - surgery</topic><topic>Obstetrics and Gynecology</topic><topic>Ovarian Diseases - blood</topic><topic>Ovarian Diseases - pathology</topic><topic>Ovarian Diseases - surgery</topic><topic>Pediatrics</topic><topic>Torsion Abnormality - blood</topic><topic>Torsion Abnormality - surgery</topic><topic>Tumor marker</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>McCarthy, Jenifer D., MD</creatorcontrib><creatorcontrib>Erickson, Kimberly M., MD</creatorcontrib><creatorcontrib>Smith, Yolanda R., MD</creatorcontrib><creatorcontrib>Quint, Elisabeth H., MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of pediatric & adolescent gynecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>McCarthy, Jenifer D., MD</au><au>Erickson, Kimberly M., MD</au><au>Smith, Yolanda R., MD</au><au>Quint, Elisabeth H., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Premenarchal Ovarian Torsion and Elevated CA-125</atitle><jtitle>Journal of pediatric & adolescent gynecology</jtitle><addtitle>J Pediatr Adolesc Gynecol</addtitle><date>2010-02</date><risdate>2010</risdate><volume>23</volume><issue>1</issue><spage>e47</spage><epage>e50</epage><pages>e47-e50</pages><issn>1083-3188</issn><eissn>1873-4332</eissn><abstract>Abstract Background Ovarian tumors are the most common gynecologic malignancy occurring in childhood, with germ cell tumors being most frequent. This contrasts with adults where epithelial tumors account for most ovarian neoplasms. Tumor markers are an integral part of the work-up and may guide management. Case A 6-year-old girl with a persistent adnexal mass was found to have a highly elevated CA-125. Other tumor markers were normal. Laparoscopy revealed an enlarged, adherent ovary. A minilaparotomy revealed an ovary filled with necrotic material. This necrotic material was excised and the ovary was spared. The pathology was consistent with necrosis. Follow-up ultrasonography and CA-125 were normal. Summary and Conclusions This case demonstrates for the first time the association of an elevated CA-125 and ovarian torsion in a pediatric patient. This benign finding allowed attempting a conservative ovary-sparing approach during the surgery even in the presence of a highly elevated CA-125. However, in general, for children CA-125 is of limited utility, as it will not affect the indication for surgical exploration of persistent masses and elevations in CA-125 may discourage ovarian conservation.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>19589703</pmid><doi>10.1016/j.jpag.2009.04.002</doi><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Adnexal mass CA-125 Antigen - blood Child Children Female Humans Laparoscopy Necrosis - blood Necrosis - pathology Necrosis - surgery Obstetrics and Gynecology Ovarian Diseases - blood Ovarian Diseases - pathology Ovarian Diseases - surgery Pediatrics Torsion Abnormality - blood Torsion Abnormality - surgery Tumor marker |
| title | Premenarchal Ovarian Torsion and Elevated CA-125 |
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