The preoperative plasma levels of fibrinopeptide-A (FPA), D-dimer (DD), and von Willebrand Factor (vWF) were measured in 125 patients with ovarian masses undergoing laparotomy and in 88 healthy nonpregnant women as controls. FPA, DD, and vWF levels were significantly higher in the 58 patients with ovarian carcinoma than in the 67 patients with benign ovarian disease or controls. FPA and DD values were significantly higher in advanced (FIGO stage III-IV) than in early ovarian carcinoma. Among patients with advanced disease, FPA and DD levels correlated with none of the common clinicopathological prognostic variables; conversely, vWF values were related to FIGO stage (IV versus III, P < 0.02) and size of residual disease after initial surgery (> 2 cm versus < or = 2 cm, P < 0.05). In conclusion, increased fibrin production and degradation occur in patients with ovarian carcinoma.