Trivia Tuesday Answer & Layla Grace

Congrats to Scarlett who answered yesterday’s Trivia Tuesday question correctly! Virtual high five for being brave enough to answer AND for being right!

  • CA-125: Our patient would have been diagnosed with “Papillary Serous Cystadenocarcinoma” of the ovaries, or simply – ovarian cancer. This specific type of ovarian cancer is the most common malignant ovarian tumor in US women over the age of 20, accounting for about 26% of malignant ovarian cancer cases. CA-125 is a protein in the Mucin family sometimes used as a biological marker of ovarian cancers. Unfortunately, this protein can be found in people who do not have cancer and can also be absent in people who do. So, while it is not widely accepted for use as a diagnostic tool, I believe what this case is getting at is that if her CA-125 were elevated prior to her hysterectomy then tracking the levels following treatment could be one way to help monitor her progress. Unfortunately, this type of cancer is usually not detected at a very early stage and tends to have a poor prognosis even with treatment. The 5-year relative survival rate, according to Wikipedia, is only about 21%. Here’s a picture of what this type of tumor sometimes looks like. Although taken at a different angle and difficult to compare, the second picture shows a normal ovary (with follicles indicative of impending ovulation). The tumor in the first picture was measured to be about 17cm, with a normal ovary being less the 5cm. That is phenomenal to me, as the case study regarding the picture described a woman undergoing exploratory laparotomy because of a bowel obstruction! That’s what is so amazing and devastating about many ovarian cancers, they simply show very few symptoms until they are quite advanced.
Serous Papillary Cystadenocarcinoma, 17cm
Image Courtesy Of: Ed Uthman
Normal Ovary, Oviduct and Follicles
Explanation Of Other Options
  • Alpha-fetoprotein is actually measured during pregnancy – elevated levels can indicate fetal neural tube defects or an abdominal defect called omphalocele while decreased levels can imply Down’s Syndrome. Alpha-fetoprotein can also be used as a marker, in a similar fashion to CA-125, for some germ cell and liver cancers. 
  • Bombesin is used as a maker for small cell lung cancer, gastric cancer and the most common non-brain tumor of childhood, Neuroblastoma.

I know a bit about Neuroblastoma from following the heart-breaking case of Layla Grace last year. Hop on over to her memorial foundation site to read Layla’s story, learn about Neuroblastoma and find out what her parent’s are doing to help fight the devastating disease that took their beautiful 2-year old daughter from them. I fully intend to blog about this little girl in the future. 

  • PSA is a marker for prostatic carcinoma.

  • S-100 is a marker for some melanoma and neural cancers.

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  • OMG yay!! Love the new feature! Now I get to be on the other side of medical mystery solving :)

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About The Author

I'm an ObGyn. I started this blog as a medical student (some would call that doctor school) and now I'm working as an Ob/Gyn, which is seriously the coolest job ever. I'm a twin mom and recently added a baby brudder to the mix. My life story through November 2010 can be viewed here. The events in the many years following can be summed up as wedding bells, books, exams, babies, and doctoring. I started this blog in hopes of landing a role in a Lifetime movie so I could quit medicine and move to Hollywood, but that hasn't if you wouldn't take medical advice from Angelina Jolie, you shouldn't take it from me. I may not even be a real person. In fact, I'm probably a spambot. Or possibly a 15 yo boy blogging from a dingy basement. If you're really interested you can read more about me here. If you have any questions or want to guest post contact me.

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