A 34-year-old woman being evaluated for infertility has a CA-125 level of 96 U/mL. She has low-grade fever, evening sweats and a doughy feel of the pelvis. Ultrasound shows loculated ascites with thick septations but no solid ovarian mass. Which condition best explains the elevated CA-125?

• A Polycystic ovarian disease
• B Subserosal uterine fibroid
• C Simple paraovarian cyst
• D Abdominal tuberculosis with peritonitis ✓

Explanation

CA-125 is raised by any process that irritates the peritoneum or inflames the mesothelium, and abdominal tuberculosis with peritonitis is a classic cause of values above 100 U/mL that closely mimic disseminated ovarian cancer, particularly in India where genital tuberculosis is prevalent. The constellation of fever, night sweats, loculated ascites and a doughy pelvis supports this. Subserosal fibroids, paraovarian cysts and polycystic ovaries do not inflame the peritoneal surface and do not produce such elevations.

Reference: Shaw's Textbook of Gynecology, 16th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.