Markedly-elevated serum CA125 in a woman with pulmonary tuberculosis

A 26-year-old Chinese woman first presented to the Singapore Anti-Tuberculosis Association with fever and cough, and was diagnosed with pulmonary tuberculosis. She was then referred to KK Women's & Children's Hospital to exclude a gynaecological pathology when she was found to have abnormally high levels of cancer antigen CA125 in a health screening done concomitantly. Pelvic examination and pelvic ultrasonography were normal. Other tumour markers (CA19-9, CEA, AFP and BHCG) were normal. The level of CA125 was monitored and returned to normal levels with anti-tuberculosis treatment. A non-gynaecological diagnosis like pulmonary tuberculosis must always be considered as one of a differential diagnosis in a woman presenting with a markedly-raised CA125.