Elevation of carcinoembryonic antigen and CA-125 in a patient with multivisceral tuberculosis

J Natl Med Assoc. 1997 Feb;89(2):142-3.

Abstract

A case of a middle-aged African-American woman with weight loss, ascites, a bilateral pleural effusion with no infiltrate, and a clinical diagnosis of a metastatic gynecological tumor is presented. Her carcinoembryonic antigen (CEA) and CA-125 levels were elevated (400 micrograms/L and 331 micrograms/L, respectively). She underwent an exploratory laparotomy and a dilation & curettage for biopsies and cultures. Pathological examination showed Langhans' type giant cells on peritoneal biopsy. An endometrial curette biopsy showed granulomatous endometritis and acid-fast bacilli. Cultures grew Mycobacterium tuberculosis. The patient presented with a fibroid tumor that could have contributed to her elevated CA-125 level, but after antituberculous treatment was started and tumor markers were repeated after 1 year, the CEA level decreased to 1.2 micrograms/L and CA-125 to 9 micrograms/L without surgical resection of the tumor. A review of the literature revealed only three cases in which patients had elevated CA-125 in multivisceral tuberculosis. No cases were reported in which both CEA and CA-125 levels were elevated in multivisceral tuberculosis. Possible causes of elevated CEA and CA-125 levels are discussed.

Publication types

  • Case Reports

MeSH terms

  • Antitubercular Agents / therapeutic use
  • CA-125 Antigen / blood*
  • Carcinoembryonic Antigen / blood*
  • Female
  • Humans
  • Leiomyoma / blood
  • Leiomyoma / complications
  • Middle Aged
  • Tuberculosis, Gastrointestinal / blood*
  • Tuberculosis, Gastrointestinal / complications
  • Tuberculosis, Gastrointestinal / drug therapy
  • Uterine Neoplasms / blood
  • Uterine Neoplasms / complications

Substances

  • Antitubercular Agents
  • CA-125 Antigen
  • Carcinoembryonic Antigen