From the Guidelines
Elevated ferritin levels in an ovarian mass are highly suggestive of a germ cell tumor, specifically a dysgerminoma 1.
Key Points to Consider
- In such cases, it is recommended to conduct further testing, including imaging studies and tumor marker analysis, to confirm the diagnosis.
- A ferritin level above 1000 ng/mL is highly suggestive of a dysgerminoma.
- If a dysgerminoma is suspected, treatment with bleomycin, etoposide, and cisplatin (BEP) chemotherapy for 3-4 cycles is often recommended, with surgery to remove the ovarian mass.
- Close monitoring of ferritin levels during treatment can help assess response to therapy.
Important Considerations
- The presence of a complex ovarian mass, with both solid and cystic components, sometimes with internal echoes and/or septations, ascites or evidence of peritoneal metastases in the presence of an ovarian mass, are features highly suggestive of advanced ovarian cancer 1.
- Transvaginal ultrasonography is often included among the procedures for the evaluation of a pelvic mass, and can help differentiate between benign and malignant conditions 1.
- Multimodal screening, including serum CA125 measurement and ultrasound imaging, may be effective in detecting ovarian cancer early, but is not yet considered the gold standard for early detection 1.
From the Research
Significance of Elevated Ferritin Levels in Ovarian Mass
- Elevated ferritin levels have been observed in patients with ovarian cancer, particularly in those with germ cell tumors 2 and epithelial ovarian cancer 3, 4, 5.
- Ferritin levels may be useful in monitoring treatment response and detecting recurrence in ovarian cancer patients 2, 4.
- The combination of serum ferritin and CA125 may improve diagnostic accuracy for epithelial ovarian cancer, particularly in early-stage disease 5.
- Elevated ferritin levels have been associated with poor prognosis in patients with germ cell tumors 2 and may be useful in detecting residual or recurrent tumor 2.
- Ferritin levels may increase with advancing disease stage in epithelial ovarian cancer 3, but the relationship between ferritin and tumor markers such as CA125 is not well established 5.
Ferritin as a Tumor Marker
- Ferritin has been evaluated as a potential tumor marker for ovarian cancer, but its sensitivity and specificity vary depending on the study population and disease stage 3, 5.
- Ferritin may be more useful as a diagnostic tool in combination with other tumor markers, such as CA125 5.
- The role of ferritin in ovarian cancer diagnosis and management requires further study to fully understand its significance and potential applications 2, 3, 4, 5.