42 yr old nulliparous women presented with signs of Hypo protenimia with pedal edema,Ascitis, breathlessness with an Albumin level of 1.2,Total proteins are low other LFTs are normal,Hb is 11 gr/dl,wbc count is normal RFTare normal.Na+ is nomal but K+is low.CXR is normal.Cosidering the above picture CA125 was done at the same time.IT was 3000,repeated still high,U/S,CT showed no abnomality except Ascitis.PET scan was done which did not show any area of uptake.Asitic fluid analysys nothing significant.she had mini gastric Bypass 9 months ago.Albumin and K+ are being corrected.
Sir,
CA125 > 3000 and high should be considered significant.
Ascitis- cell block and IHC
UGI scopy
may be useful.
Dear colleague,
CA-125 is characteristic and the most frequently used biomarker for ovarian cancer detection. I would recommend that the lady should visit a gynecologist first of all.
[Suh KS, Park SW, Castro A, Patel H, Blake P, Liang M, Goy A (Nov 2010). "Ovarian cancer biomarkers for molecular biosensors and translational medicine". Expert Review of Molecular Diagnostics. 10 (8): 1069–83. PMID 21080822],
etc.
Good luck
Signet ring adenocarcinoma is PET Negative.
CT might have not picked up small deposits/mucosal lesion.
Consider doing other serum tumor markers- CA19.9
MGB was reversed,ascites has settled,but still albumin level is low but better than before.CA125 still elevated but much lower.CA199,CEA are normal.
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