An unusual evolution of the serum CA 125 level in a ovarian cancer patient

The usefulness of serum CA 125 measurements in monitoring ovarian cancer has been firmly established in recent years. The CA 125 levels correlate well with tumor status, have a predictive value for second-look operations, indicate responsiveness to chemotherapy, and are a strong independent prognostic factor for survival. We report here a patient with an unusual evolution of the CA 125. The primary treatment consisted of surgery and whole-abdomen radiation followed by adjuvant alkylating agent chemotherapy. Six months after the primary treatment the normal CA 125 level increased to a pathological value during the adjuvant treatment. No tumoral progression could be documented and without changing the medication the value progressively decreased to normal values over a period of 18 months. Actually almost 5 years later the CA 125 remains normal and the patient disease free. After discussion of the different etiologic possibilities the most probably explanation seems to be a radiation-induced peritoneal inflammation. The time interval, the rapid increase, and the progressive decrease of the CA 125 level all correlate well with the histopathological appearance of chronic radiation toxicity.