Ischemic stroke associated with adenomyosis with marked elevation of serum CA125 level

A 51-year-old woman with adenomyosis developed vertigo during menstruation. Brain MRI demonstrated acute multiple infarcts. Blood tests showed marked elevation of fibrin degradation products (428.8 mu g/mL, reference range: <5.0 mu g/mL) and CA125 (4276.7 U/mL, reference range: <35.0 U/mL). Whole-body CT using contrast medium demonstrated a uterine mass, which was not accompanied by deep vein thrombosis, pulmonary thromboembolism, cardioaortic abnormalities, or cancer. Pelvic MRI demonstrated thickening of the posterior myometrium, consistent with the finding of adenomyosis. Anticoagulation therapy and hormonal therapy for adenomyosis prevented recurrence of ischemic stroke. Our case suggests that serum CA125 level can exceed 100 times the upper reference limit even in patients with adenomyosis and that adenomyosis with marked elevation of serum CA125 causes ischemic stroke.