Carcinoembryonic antigen elevation due to bowel sequestration with mucocele formation following colonic resection.
Carcinoembryonic antigen (CEA) is recommended as a serologic marker to monitor colorectal carcinoma recurrence. Elevations of CEA due to causes other than carcinoma exist and may lead to a misdiagnosis of recurrent carcinoma. We report a case of bowel sequestration with mucocele formation at the site of previous colo-colic anastomosis causing a mild elevation in CEA. The patient exhibited increasing CEA levels 6 years after resection of a sigmoid colon carcinoma with end-to-end anastomosis. Subsequently, computed tomographic and positron emission tomographic scans documented the presence of a cystic mass showing increased uptake at the anastomotic site. At exploratory laparotomy a mass lesion with mucus-filled protrusions was resected. Pathologic examination documented the presence of sequestration of a segment of the bowel wall with a mucocele and no overlying defect at the mucosal anastomotic site by demonstrating the presence of all bowel layers. After resection of the lesion, the CEA level normalized.
Haber
Marian M
MM
Department of Pathology & Laboratory Medicine, Graduate Hospital, Drexel University College of Medicine, Philadelphia, Pa 19146, USA. marian.haber@drexel.edu
Leon
Marino E
ME
Bakker
Jennifer E
JE
Nagle
Deborah
D
D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D000368:Aged; D000714:Anastomosis, Surgical; D002272:Carcinoembryonic Antigen / Q000097:blood*; D003106:Colon / Q000601:surgery*; D003108:Colonic Diseases / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008297:Male; D009078:Mucocele / Q000175:diagnosis* / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D012811:Sigmoid Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D014055:Tomography, Emission-Computed; D014057:Tomography, X-Ray Computed
D002272:Carcinoembryonic Antigen