혈청 종양표지자 CA125가 극도로 상승한 자궁샘근육종 1예
A case of extremely elevated CA 125 with adenomyosis
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초록
혈청 CA 125는 상피성 난소암 환자의 진단 및 경과관찰에 유용하게 사용되고 있지만 자궁샘근육종, 자궁근종, 골반내 염증, 자궁내막증 등의 양성질환뿐 아니라 임신이나 월경과 같은 정상적 생리조건하에서도 상승하는 것으로 알려져 있다. 그러나 난소암 등 악성질환을 제외하면 혈청 CA 125치의 상승은 제한적이라 100 IU/mL을 넘는 경우는 드물다. 자궁샘근육종은 자궁내막 선조직과 기질이 자궁근층 속으로 파고드는 병리적 상태를 말한다. 저자 등은 악성 질환을 동반하지 않은 상태에서 혈청 CA 125치가 1,000 IU/mL 이상 극도로 상승한 예를 경험하였다. 환자에게 시험적 복강경을 통해 LAVH (Laparoscopic vaginal hysterectomy)와 복막 조직검사를 시행하였다. 조직 검사결과 자궁샘근육종으로 확진되었으며 수술 5일 후 환자의 혈청 CA 125치는 38 IU/mL로 정상화되었다.
Abstract
We report a very high serum level of serum CA 125 in a patient with adenomyosis. Elevated serum CA 125 is useful for the management of patients with ovarian cancer but has also been associated with several benign conditions, including adenomyosis, uterine fibroids, pelvic inflammatory disease, pregnancy, menstruation, and endometriosis. Adenomyosis refers to the endometrial glands and stroma located deep within the myometrium. Here we report a patient with an elevated, rising serum CA 125 level over 1,000 IU/mL without any malignancy. Exploratory laparoscopy with LAVH (Laparoscopically assisted vaginal hysterectomy) and multiple peritoneal biopsies were performed. Histologically, the lesion was confirmed to be an adenomyosis. The level of serum CA 125 was 38 IU/mL on the fifth postoperative day.
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