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Uterine Cancer
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Claudia von Arx, Hani Gabra, Christina Fotopoulou
After standard primary treatment, follow-up should be 3-monthly for 3 years, then 6-monthly for a further 2 years, and then annually. Vault smears can be used in surveillance follow-up but can cause significant and disruptive diagnostic uncertainty after adjuvant radiotherapy and are in general not as sensitive as cervical pap smears. The follow-up should include careful history of symptoms, clinical examination, vaginal and rectal examination, and transabdominal and transvaginal ultrasound. Where careful vaginal examination reveals an apparent recurrence, a formal incisional biopsy should be taken. Patients who have recurrent tumors should always see a gynecological oncologist with an interest in this condition. CA 125 antigen levels are unhelpful apart from in some papillary serous variants.
Pregnancy-Related Proteins in Non-Trophoblastic Tumors
Published in Gábor N. Than, Hans Bohn, Dénes G. Szabó, Advances in Pregnancy-Related Protein Research, 2020
Torre et al.200 found levels higher than the cut-off of CA 125 antigen in 80% of endometriomas, and after surgery a progressive decrease to the normal level was observed within 20 d as a mean. All this indicates that CA 125 — a generally accepted tumor marker — and beta lactoglobulin homologue PP14 levels in the bloodstream of patients suffering from endometriosis change parallelly. Clarification of the ectopic synthesis of PP14 and the pathophysiological and clinical significance of the protein will require further study in the near future.
Tumour Markers in Gynaecology
Published in Tony Hollingworth, Differential Diagnosis in Obstetrics and Gynaecology: An A-Z, 2015
The most widely use marker in gynaecology is cancer-associated antigen (CA) 125. This was first described in 1981 (Bast). The CA-125 antigen is a large transmembrane glycoprotein derived from coelomic (pericardium, pleura, peritoneum) and Müllerian (fallopian tubal, endometrial, endocervical) epithelia.
Hyperthyroidism associated with struma ovarii – a case report and review of literature
Published in Gynecological Endocrinology, 2021
Agnieszka Podfigurna, Anna Szeliga, Paulina Horwat, Marzena Maciejewska-Jeske, Blazej Meczekalski
In the literature, SO was reported more often on the right side (10 cases) than on the left side (8 cases). The CA-125 antigen was markedly elevated in our patient, at a similar concentration to that observed in other cases reported in the literature [14, 16, 19]. A case report by Frysak et al. [20], however, found the CA-125 to be within normal limits. Additionally, a summary study of 68 reported cases of SO [31] found that only 15% of patients had an elevated preoperative CA-125. This further enforces that CA-125 is a useful prognostic antigen, yet not a diagnostic one. A high serum CA-125 may be associated with Meigs or Pseudo-Meigs syndrome, but does not correlate with the severity of malignancy. Evidence in the literature has shown that malignant SO was not accompanied by a rise in CA-125 [24, 28]. Nuclear medicine methods such as technetium-pertechnetate-99m (99mTc) or iodine-123 radioisotope (123I) whole-body scans have been used to diagnose SO [2, 4]. When undergone by patients in a hyperthyroid state, the isotope uptake observed in the thyroid is usually insufficient to explain the physical manifestations of symptoms. An increased uptake in the pelvis region may suggest a teratoma. It is important to remember that metastasis from a primary thyroid cancer may have a similar presentation, and as such, this must be kept high on differential diagnosis list [3]. Although in most of the cases the preliminary immunological findings were accurate, and a positive TSHR-Ab correlated with SO, antibodies above the normal range were only found in 95% of the patients [6]. This should be taken into consideration when interpreting results. It should also be noted that antibody testing is positive for both functioning and nonfunctioning SO. Final and definitive confirmation of an active SO is often made, when following tumor excision, and the patient falls into a hypothyroid state. Additional immunohistological staining for TSHR can be used for confirmation [3]. This supports the suggested hypothesis regarding the pathophysiology of SO, where TSHR antibodies stimulate the TSH receptors in the ovarian tissue in a similar way that they would interact with the thyroid receptor in the thyroid and cause Graves’ disease.