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I read with interest the article on malignant ascites by Aslam and Marino.¹ The detailed description of the pathogenesis of malignant ascites is very informative. However, I would like to comment on the diagnostic role of serum tumor markers in patients with malignant ascites. I do not agree with the authors' statement that "an elevated serum cancer antigen 125 [CA-125] level . . . is highly suggestive of ovarian carcinoma." On the contrary, I would like to say that tumor markers are nonspecific and their presence or absence does not include or exclude any malignancy, respectively. A markedly elevated level of CA-125 even in the presence of malignant ascites and an ovarian mass is not diagnostic of an ovarian epithelial cancer. To support this, I present herein a brief case report.

A 46-year-old woman presented with a 6-week history of shortness of breath, weight gain, and increase in waist size. . . . [Full Text of this Article]

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Malignant Ascites: New Concepts in Pathophysiology, Diagnosis, and Management
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Arch Intern Med. 2001;161(22):2733-2737.
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