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Paper text:
hydrometrocolpos is a rare congenital anomaly formed by cystic dilatation of vagina and uterus due to conditions like imperforated hymen , distal vaginal atresia or transverse vaginal septum .
ca 19 - 9 is widely used as a tumor marker for cancers of the pancreas , stomach , colon , cholangial duct , ovaries , endometrium , and lung ( adenocarcinoma ) . however
, several benign conditions are also known to increase serum ca 19 - 9 levels .
ca 125 is an antigenic determinant widely used for screening of ovarian , pancreatic , breast , colon and lung cancers .
it also increases in some benign and physiological conditions like pregnancy , menstruation and endometriosis .
the baby was born to 28 years old healthy mother in the 38th gestational week by cesarean section with an apgar score at 1 and 5  min were 8 and 9 , respectively .
the birthweight , height and head circumference were 3940  g ( > 90p ) , 50  cm ( 5075p ) and 34.8  cm ( 5075p ) , respectively . in the prenatal period
the newborn was diagnosed with giant cystic mass that fills the all the abdominal cavity and amniotic fluid volume was normal . in preliminary diagnosis bilateral polycystic kidneys was reported . after the delivery ,
the patient was intubated because of respiratory failure . in the follow - up of patient
requiring mechanical ventilation support with low pressure and there is good ventilation on chest radiograph we did not accept pulmonary hypoplasia . the main cause of intubation accepted as the compression of abdominal mass .
laboratory data ( white cell count , c - reactive protein , biochemical tests ) were normal .
abdominal ultrasound showed a cystic structure posterior to the urinary bladder measuring 61    46    77  mm , with a thick wall structure and anechoic fluid level , and dilatation of ureters ( fig .
abdominal computed tomography confirmed the presence of a cystic structure in the uterine compartment ( fig .
the urinary outflow decreased in the postnatal 12th hour , which was thought to be compression by the mass and thus 400  ml of fluid was aspirated underwent ultrasound guided percutaneous drainage .
biochemical , cytological and microbiological analysis of the drainage fluid revealed no pathology . among the tests performed for differential diagnosis , levels of alpha - fetoprotein and beta - hcg were normal but serum ca 19 - 9 level was 110.1 u / ml ( reference value : < 27  u / ml ) and ca 125 level was 278.7  u / ml ( reference value : < 35  u / ml ) .
the urinary system was found to be normal but distal vaginal atresia was found with cystoscopy .
the drainage level decreased and ceased on the 7th day and abdominal distention did not recur . on the 8th day
the levels of ca 19.9 and ca 125 turned back to normal ( 17  u / ml and 21  u / ml respectively ) . in the follow - up of patient requiring mechanical ventilation support with low pressure was discontinued on the eighth day .
hydrometrocolpos is a rare congenital anomaly with an estimated incidence of 0.13.8 % ( 3 ) . during the newborn period
the condition occurs as a result of accumulation of cervical and vaginal secretions due to the obstruction of vaginal outlet .
most cases present with abdominal mass , recurrent urinary tract infections or primary amenorrhea in the pubertal period . in the neonatal period it may present with abdominal mass , recurrent urinary tract infection , sepsis , obstructive uropathy and respiratory failure .
ca 19 - 9 is widely used as a tumor marker for pancreatic , colon , ovarian , endometrial and lung carcinoma .
however several benign conditions such as inflammatory or proliferative diseases ( cholangitis , pancreatitis , bronchial cyst , bronchiectasis , pulmonary fibrosis , endometriosis , pregnancy and ovarian cysts ) , ductal obstructions ( pancreatic and choledochal ) and chronic diseases ( hepatitis , glomerulonephritis , diabetes mellitus , hemodialysis , peritoneal dialysis ) also increase serum ca 19 - 9 levels .
ca 125 is also used as a tumor marker for ovarian , pancreatic , breast , colon and lung carcinomas .
also some other physiologic conditions such as pregnancy and menstruation can cause elevated serum ca 125 levels . in a study which evaluated patients with ca 125 levels over 1000  u / ml ; 37% of patients had non - malignant gynecological disease ( 43.9% endometriosis , 12.2% adenomyosis , 9.7% pelvic inflammatory disease , 7.3% uterine leiomyoma , 2.4% imperforated hymen ) .
however serum ca 125 levels in non - malignant gynecological diseases were significantly lower than those in malignant diseases .
there is two case report with elevated levels of ca 19 - 9 and ca 125 in hydrometrocolpos due to imperforated hymen which is a benign condition .
both reported cases were in premenarcheal age group and the levels were both higher than our case .
this is the first incident reported in literature in the neonatal period presenting with hydrometrocolpos and elevated levels of ca 19 - 9 and ca 125 .
hydrometrocolpos is a rare benign condition which may be kept in mind in girl newborn baby with abdominal mass and associated with high ca 19 - 9 and ca 125 levels .
highlightshydrometrocolpos is a rare congenital malformation of the female in neonate.ca 19 - 9 and ca 125 are widely used as tumor markers , however several benign conditions are also known to increase levels.here we report a newborn with hydrometrocolpos due to distal vaginal atresia and elevated serum ca 19 - 9 and ca 125 levels .