{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T17:18:12Z","timestamp":1790961492459,"version":"4.1.0"},"reference-count":8,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,9,3]],"date-time":"2020-09-03T00:00:00Z","timestamp":1599091200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,9,3]],"date-time":"2020-09-03T00:00:00Z","timestamp":1599091200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>The presence of a suspicious ovarian cyst with elevated cancer antigen 125 level in a woman of reproductive age poses a serious therapeutic dilemma. Mature cystic teratomas and mucinous cystadenomas may also cause an increase in cancer antigen 125.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Case presentation<\/jats:title>\n<jats:p>A 43-year-old Sinhalese woman with a history of anovulatory subfertility for 5\u2009years presented with heavy menstrual bleeding and secondary dysmenorrhea of 6\u2009months\u2019 duration. Imaging (pelvic ultrasound and computed tomography of the abdomen and pelvis) revealed a hemorrhagic cyst (6 \u00d7 4\u2009cm) on the right side and a multilocular cyst with solid areas (10 \u00d7 7\u2009cm) on the left side. Her cancer antigen 125 level was 2715 U\/ml. Following a multidisciplinary team meeting, a fertility-sparing staging laparotomy was performed, which included right cystectomy, left oophorectomy, infracolic omentectomy, and peritoneal washings. Histology revealed a mucinous cystadenoma of the right ovary and a mature cystic teratoma on the left ovary. No malignant cells were observed in peritoneal washings. The patient\u2019s cancer antigen 125 level dropped to 74.8 U\/ml 1 month after surgery.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Rarely, teratomas and mucinous cystadenomas may also give rise to an extremely high cancer antigen 125 level. The risk of malignancy index and risk of malignancy algorithm may both be misleading in these instances. Therefore, multidisciplinary input, fertility-sparing surgery, and follow-up are paramount to achieve optimal treatment and patient satisfaction.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s13256-020-02458-x","type":"journal-article","created":{"date-parts":[[2020,9,2]],"date-time":"2020-09-02T23:05:52Z","timestamp":1599087952000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Elevated CA 125 level in a mucinous cystadenoma and a teratoma: a case report"],"prefix":"10.1186","volume":"14","author":[{"given":"Chanil Deshan","family":"Ekanayake","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nayoman","family":"Munasinghe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iranthi","family":"Kumarasinghe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sachini","family":"Rasnayake","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,9,3]]},"reference":[{"key":"2458_CR1","first-page":"698","volume-title":"Robbins basic pathology","author":"V Kumar","year":"2013","unstructured":"Kumar V, Abbas AK, Aster JC. 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Correlation of ultrasound features and the risk of ovarian malignancy algorithm score for different histopathological subtypes of benign adnexal masses. Medicine (Baltimore). 2018;97(31):e11762. https:\/\/doi.org\/10.1097\/MD.0000000000011762.","journal-title":"Medicine (Baltimore)"},{"key":"2458_CR5","doi-asserted-by":"publisher","first-page":"230","DOI":"10.12659\/MSM.883865","volume":"19","author":"HY Cho","year":"2013","unstructured":"Cho HY, Kim K, Jeon YT, Kim YB. CA19-9 elevation in ovarian mature cystic teratoma: discrimination from ovarian cancer - CA19-9 level in teratoma. Med Sci Monit. 2013;19:230\u20135.","journal-title":"Med Sci Monit"},{"key":"2458_CR6","first-page":"5","volume":"43","author":"L Dong","year":"2008","unstructured":"Dong L, Cui H, Li XP, et al. Clinical value of serum CA19-9, CA125 and CP2 in mucinous ovarian tumor: a retrospective study of 273 patients [in Chinese]. Zhonghua Fu Chan Ke Za Zhi. 2008;43:5\u20138.","journal-title":"Zhonghua Fu Chan Ke Za Zhi"},{"key":"2458_CR7","volume-title":"Fertility-sparing treatments in gynaecological cancers","author":"Royal College of Obstetricians and Gynaecologists","year":"2013","unstructured":"Royal College of Obstetricians and Gynaecologists. Fertility-sparing treatments in gynaecological cancers. Scientific impact paper no. 35. 2013."},{"key":"2458_CR8","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/j.ygyno.2018.08.025","volume":"151","author":"M Lycke","year":"2018","unstructured":"Lycke M, Kristjansdottire B, Sundfeldt KA. A multicenter clinical trial validating the performance of HE4, CA125, risk of ovarian malignancy algorithm and risk of malignancy index. Gynecol Oncol. 2018;151:159\u201365.","journal-title":"Gynecol Oncol"}],"container-title":["Journal of Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-020-02458-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13256-020-02458-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13256-020-02458-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,3]],"date-time":"2021-09-03T13:44:24Z","timestamp":1630676664000},"score":1,"resource":{"primary":{"URL":"https:\/\/jmedicalcasereports.biomedcentral.com\/articles\/10.1186\/s13256-020-02458-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,3]]},"references-count":8,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["2458"],"URL":"https:\/\/doi.org\/10.1186\/s13256-020-02458-x","relation":{},"ISSN":["1752-1947"],"issn-type":[{"value":"1752-1947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,3]]},"assertion":[{"value":"8 May 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 July 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 September 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"141"}}