Constrictive pericarditis with elevated CA 125 mimicking ovarian carcinoma

THE CLINICAL DIAGNOSIS of constrictive pericarditis can be difficult and is often missed because of the nonspecific nature and insidious onset of its signs and symptoms; fatigue, shortness of breath, pleural effusions and ascites are the most common manifestations. Ovarian cancer is also often diagnosed in an advanced stage because of lack of early clinical manifestations or appropriate screening tests. Abdominal distension and ascites are the most frequent findings among patients with advanced ovarian carcinoma. Several investigators have attempted to isolate tumor-specific antigens that could be used for serologic diagnosis of ovarian tumors. Although cancer antigen 125 (CA 125) was found to be useful, higher levels have also been noted in other malignant and non-malignant diseases. We describe a case of constrictive pericarditis with elevated CA 125 masquerading as ovarian cancer.