Case Report
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World J Hepatol. Feb 27, 2013; 5(2): 86-89
Published online Feb 27, 2013. doi: 10.4254/wjh.v5.i2.86
Myxedema ascites with high CA-125: Case and a review of literature
Bou Khalil Roula, El Rassi Patrick, Chammas Nizar, Obeid Jean, Ghabach Maroun, Sakr Charles, Itani Tarek, Farhat Said
Bou Khalil Roula, El Rassi Patrick, Chammas Nizar, Obeid Jean, Ghabach Maroun, Sakr Charles, Itani Tarek, Farhat Said, Quarantaine Governmental University Medical Hospital, Beirut 961, Lebanon
Bou Khalil Roula, Farhat Said, Saint Georges University Medical Center, University of Balamand, Beirut 961, Lebanon
El Rassi Patrick, Chammas Nizar, Obeid Jean, Ghabach Maroun, Sakr Charles, Department of Surgery, Lebanese University, Beirut 961, Lebanon
Ghabach Maroun, Chairman of Anesthesia Department, Rosary Hospital, Beirut 961, Lebanon
Author contributions: All authors had access to the data and wrote the manuscript.
Correspondence to: Farhat Said, MD, Quarantaine Governmental University Medical Hospital, Beirut 961, Lebanon. saidfarhat@hotmail.com
Telephone: +961-3-636211 Fax: +961-1-443516
Received: May 19, 2012
Revised: November 16, 2012
Accepted: December 1, 2012
Published online: February 27, 2013
Abstract

Ascites appearing in a previously healthy female patient is usually ascribed to a variety of causes, among which, is a cancerous process, especially if it comes with a raised CA-125 level. Although the CA-125 antigen is present on more than 80% of malignant epithelial ovarian tissue of non-mucinous type, it is also found on both healthy and malignant cells of mesothelial and non-mesothelial origin. Myxedema ascites which is caused by hypothyroidism is a rare entity, but on the other hand is easy to treat. It is one of the differential diagnoses when the ascites is refractory to treatment and no other obvious cause can be identified. If the diagnosis is delayed, patients will frequently receive unnecessary procedures, while treatment has very good response rates and ascites resolve with serum CA-125 normalization after adequate hormonal treatment.

Keywords: Hypothyroidism; Refractory ascites; High CA-125; Hormonal therapy; Abdominal paracentesis