abstract: Serum HE4 levels are less frequently elevated than CA125 in women with benign gynecologic disorders

Serum HE4 levels are less frequently elevated than CA125 in women with benign gynecologic disorders: Publication year: 2012


Objective
The human epididymis protein 4 (HE4) is a novel biomarker for ovarian cancer. This study measured the HE4 and CA125 levels in women with benign gynecological disorders. 

Study Design 
Sera were obtained from women prior to surgery for a pelvic mass and HE4 and CA125 levels were determined. The proportions of patients with elevated biomarker levels were compared.

Results 
There were 1042 women with benign disease. HE4 levels were less often elevated than CA125 (8% vs 29%) . A marked difference was observed in patients with endometriosis in which HE4 was elevated in 3% of patients and CA125 in 67% . Serous ovarian tumors were associated with elevated levels of HE4 in 8% of patients and CA125 in 20%; uterine fibroids in 8% vs 26% ; dermoids in 1% vs 21% ; and inflammatory disease in 10% vs 37% .

Conclusion
HE4 is elevated less frequently than CA125 in benign disease, particularly in premenopausal patients.

Surgical management of ovarian disease in infants, children, and adolescents: a 15-year review

RESULTS: A total of 231 patients were evaluated in this study, with a mean age of 12.8 years (range, 3 weeks to 20 years). There were 221 (95.7%) benign lesions and 10 (4.3%) were malignant.

Peri- and post-menopausal incidental adnexal masses and the risk of sporadic ovarian malignancy: new insights and clinical management.

Abstract

Adnexal masses are common among peri- and post-menopausal women. Although ovarian cancer is a significant cause of mortality in menopausal women, large population-based studies demonstrate that the majority of adnexal masses are benign. Despite this, the appearance of an adnexal mass is a concern for the patient and an insight exercise for physicians. In most cases, an adnexal enlargement is an incidental finding, generally corresponding to a benign cyst and easily diagnosed by conventional ultrasound. Exceptionally an ovarian tumour may be malignant and should be treated as early as possible. When conventional ultrasound renders complex morphology other diagnostic tools must be used such as: colour Doppler and functional tumour vessel properties, serum CA 125 levels, nuclear magnetic resonance imaging and in some cases laparoscopy. Several new tumour markers are being studied for clinical application, although there are presently no clear recommendations. Adnexal masses with benign morphological and functional properties must be periodically monitored as an alternative to surgery since malignant transformation is exceptional.

A Longitudinal Investigation of Psychological Disorders in Patients Prior and Subsequent to a Diagnosis of Ovarian Cancer

Abstract and full free text available: Pelvic mass associated with raised CA 125 for benign condition: A case report

Note: this paper also discusses differences between ultrasound/CT/MRI

Abstract
Background
Raised CA 125 with associated pelvic mass is highly suggestive of ovarian malignancy, but there are various other benign conditions that can be associated with pelvic mass and a raised CA 125.
Case presentation
We present a case of 19 year old

Evaluation of the risk of malignancy index in daily clinical management of adnexal masses

Conclusions

"In our study population, introduction of the RMI would improve the management of adnexal masses, with a higher percentage of ovarian cancer patients that are operated by a gynecologic oncologist. At the same time, referral of patients with non-invasive (benign and borderline) lesions would be reduced."

Should the ovaries be removed or retained at the time of hysterectomy for benign disease? Human Reproduction Update