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The Journal of the Royal Society for the Promotion of Health, Vol. 120, No. 1, 47-51 (2000)
DOI: 10.1177/146642400012000118

Lessons to be learned: a case study approach: Ascites and elevated serum CA 125 due to a pancreatic carcinoma. A diagnostic dilemma

A.S.M. Ahmed

Trust Registrar, Obstetrics and Gynaecology Department, East Surrey Hospital, Redhill, Surrey

M. Long

East Surrey Hospital, Redhill, Surrey

D. Donaldson

East Surrey Hospital, Redhill, Surrey and Crawley Hospital, Crawley, West Sussex

A 72 year-old lady with unrecognised cancer of the body of the pancreas presented with a 4-month history of progressive loss of weight and ascites. The results of laboratory investigations were either negative or within normal limits - apart from a raised serum CA 125 level; no tumour mass was detected on diagnostic imaging. She underwent exploratory laparotomy for a suspected ovarian tumour, but this proved not to be the correct diagnosis. A serum CA 19-9 level was subsequently requested and found to be significantly raised; a second contrast CT scan then showed the presence of ill-defined peri-aortic tissue. A further exploratory laparotomy was carried out in order to establish the true nature of the problem; a large pancreatic carcinoma was revealed.

Key Words: Ascites • pancreatic carcinoma • serum CA 125 • serum CA 19-9 • non-ovarian cancer


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