TY - JOUR JO - Menopause Review/Przegląd Menopauzalny SN - 1643-8876 VL - 20 IS - 3 PY - 2021 ID - Mulita2021 TI - An enormous pelvic tumor in a 46-year-old woman with an elevated serum CA 125 level, what lies beneath it? Investigation of uterine tumors in postmenopausal women AB - Abdominal and pelvic pain with an associated pelvic mass is a very common emergency situation. There is always a management dilemma for most emergency physicians regarding these patients. A 46-year-old postmenopausal woman was admitted to our emergency department (ED) with complaints of massive abdominal distention. Abdominal and pelvis magnetic resonance imaging (MRI) was performed, which revealed a huge pelvic abdominal mass. All tumor markers were within normal limits. However, the ovarian cancer antigen (CA 125) level was elevated. As there was a strong suspicion of malignancy, the patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy. Her final histopathology report was suggestive of uterine leiomyoma. Uterine leiomyomas are the most common benign uterine tumors in women. Surgical treatment is the gold standard, especially for older women with severe symptoms and no desire for future fertility. Although the combination of a pelvic tumor and a high-level of CA 125 arouses suspicion of gynecological malignancy, other benign conditions should always be considered in the differential diagnosis. There is limited evidence to support an association between elevated CA 125 levels and uterine fibroids so far. However, conditions such as the coexistence of adenomyosis and tumor size can affect the level of this marker in uterine fibroids. AU - Mulita, Francesk AU - Liolis, Elias AU - Kehagias, Dimitrios AU - Tchabashvili, Levan AU - Kaplanis, Charalampos AU - Iliopoulos, Fotios AU - Perdikaris, Ioannis AU - Kehagias, Ioannis SP - 154 EP - 157 DA - 2021 DO - 10.5114/pm.2021.109773 UR - http://dx.doi.org/10.5114/pm.2021.109773 ER -