Progesterone Levels in Mucinous Ovarian Tumors
Progesterone levels are typically elevated in patients with mucinous ovarian tumors, with higher levels correlating with larger tumor volumes, and these tumors appear capable of autonomous progesterone secretion regardless of malignancy status.
Progesterone Secretion Patterns
The most definitive evidence comes from a study measuring both peripheral serum and ovarian venous blood progesterone concentrations in postmenopausal women with ovarian tumors 1. Key findings include:
- Mucinous ovarian tumors were associated with the highest progesterone levels compared with other histologic types of ovarian tumors 1
- Peripheral serum progesterone concentrations were significantly elevated in all ovarian tumor groups (malignant, borderline, and benign) compared with controls without ovarian neoplasm 1
- The stage of malignancy had no effect on progesterone secretion—there was no difference in progesterone levels between malignant and benign mucinous tumors 1
Correlation with Tumor Characteristics
Progesterone levels demonstrate a clear relationship with tumor burden:
- Patients with tumor volumes exceeding 1,000 ml had higher progesterone levels than those with smaller tumors, in both peripheral and ovarian venous blood 1
- This size-dependent relationship suggests that the total mass of hormone-secreting tumor tissue drives progesterone production 1
Clinical Implications
While progesterone levels are elevated in mucinous ovarian tumors, they do not serve as useful markers for distinguishing benign from malignant disease since levels are similarly elevated across all categories 1. The primary clinical workup for mucinous ovarian tumors should instead focus on:
- Gastrointestinal tract evaluation and CEA levels to rule out occult GI primary metastatic to the ovaries 2
- Standard imaging and comprehensive surgical staging including mandatory appendectomy 2, 3
- Serum CA-125, CA-199, CA-242, and CEA monitoring for malignant transformation 4
Important Caveat
Progesterone receptor presence (not progesterone levels) may have therapeutic implications in endometrioid ovarian carcinoma, where progesterone treatment reduces cell survival in PR-positive tumors 5. However, this finding does not extend to mucinous carcinoma, where progesterone treatment showed no effect on cell survival 5.