title: Mucinous biliary cystadenoma with mesenchymal stroma: expressions of CA 19-9 and carcinoembryonic antigen in serum and cystic fluid.
abstract: A case of mucinous biliary cystadenoma with mesenchymal stroma (CMS tumor) in a 64-year-old woman is reported. The patient presented with acute abdominal pain and a palpable mass in the upper abdomen. Computed tomography and abdominal sonography showed characteristic multilocular cysts in the left lobe of the liver. Serum CA 19-9 was elevated to 108 U/ml with normal carcinoembryonic antigen (CEA) and alpha-fetoprotein (AFP) levels. The levels of CA 19-9 and CEA in the cystic fluid were high at 7430 U/ml and 576 ng/ml, respectively. The serum CA 19-9 returned to 35 U/ml 4 weeks after tumor resection. These corresponding findings of both tumor markers in the serum and cystic fluid imply that (1) CA 19-9 and CEA both exist in the epithelial component of CMS tumors as evidenced by immunohistochemical stain, (2) serum CA 19-9 is a valuable marker in the diagnosis and monitoring of CMS, and (3) in cystic fluid, there are more significantly high levels of CA 19-9 in CMS compared with levels in simple cyst and polycystic liver disease. Therefore, measurement of CA 19-9 in cystic fluid and serum may be helpful in the differential diagnosis of hepatic cystic lesions.
authors.affiliation: Department of General Surgery and Pathology, China Medical College and Hospital, Taichung, Taiwan.
authors.forename: J H
authors.initials: JH
authors.lastname: Lee
authors.forename: D R
authors.initials: DR
authors.lastname: Chen
authors.forename: S C
authors.initials: SC
authors.lastname: Pang
authors.forename: Y S
authors.initials: YS
authors.lastname: Lai
mesh_terms: D000792:Angiography; D001661:Biliary Tract Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D014408:Biomarkers, Tumor / Q000378:metabolism*; D018395:CA-19-9 Antigen / Q000032:analysis* / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000032:analysis* / Q000097:blood; D018291:Cystadenoma, Mucinous / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D014057:Tomography, X-Ray Computed
chemical_list: D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen