title: [Lung cancer with small intestine metastasis characterized by exceptionally high levels of serum CA 19-9].
abstract: A 59-year-old man was given a diagnosis of lung cancer (moderately differentiated tubular adenocarcinoma) with left adrenal gland and bone metastases in January 1997, and received chemotherapy and irradiation therapy. In late May, anemia and occult blood were detected, with a marked increase in serum CA 19-9. In August, the patient was admitted to our department complaining of melena. His serum CA 19-9 level on admission was significantly elevated (18,960 U/ml). After admission, symptoms of ileus developed. Radiographs of the small intestine and abdominal computed tomographic scans suggested the presence of a tumor in the small intestine. Therefore, surgery was performed, revealing a tumor in the jejunum, which was histologically diagnosed as metastasis of lung cancer to the small intestine. Immunohistochemical staining for CA 19-9 was more intense in specimens from the small intestine tumor than from lung cancer specimens. Serum CA 19-9 decreased significantly after resection. The clinical course and results of CA 19-9 staining suggested that CA 19-9 production by the metastatic lesion in the small intestine was the major cause of the patient's high serum CA 19-9 level. This appears to be a rare case because, to our knowledge, there are no previous reports in the Japanese literature on patients with small intestine metastasis from lung cancer showing an exceptionally high level of serum CA 19-9.
authors.affiliation: Department of Internal Medicine, National Health Insurance Sekigahara Hospital, Gifu, Japan.
authors.forename: F
authors.initials: F
authors.lastname: Asano
authors.forename: T
authors.initials: T
authors.lastname: Matsushita
authors.forename: T
authors.initials: T
authors.lastname: Shinoda
authors.forename: T
authors.initials: T
authors.lastname: Kato
authors.forename: K
authors.initials: K
authors.lastname: Sano
authors.forename: C
authors.initials: C
authors.lastname: Komaki
authors.forename: H
authors.initials: H
authors.lastname: Kawamura
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000473:pathology / Q000556:secondary*; D018395:CA-19-9 Antigen / Q000097:blood*; D006801:Humans; D007580:Jejunal Neoplasms / Q000097:blood / Q000473:pathology / Q000556:secondary*; D008175:Lung Neoplasms / Q000097:blood / Q000473:pathology*; D008297:Male; D008875:Middle Aged
chemical_list: D018395:CA-19-9 Antigen