[Chlamydia mimics suspected ovarian cancer in a 21-year-old patient].

BACKGROUND

The antigen CA125 is mainly known as a tumour marker in ovarian cancer, but may also be elevated in benign gynaecological disorders and non-gynaecological diseases.

CASE DESCRIPTION: We examined a 21-year-old patient in the gynaecological oncology outpatient clinic, after she was referred with abnormal ovaries on ultrasound and a significantly elevated CA125. The patient had seen a gynaecologist four weeks earlier because of persistent abdominal pain, deep dyspareunia and vaginal bleeding after insertion of a Mirena IUD that has since been removed. The IUD turned out to be placed in the presence of an undiagnosed STD (Chlamydia), which seems to explain the abnormal ovaries and elevated tumour marker due to pelvic inflammatory disease (PID).

CONCLUSION

PID can present atypically resembling ovarian carcinoma. Before inserting an IUD, evaluation of sexual history is essential to estimate the risk of an STI and, if necessary, to perform diagnostics.