title: A case report of spontaneous rupture of intracranial epidermoid cyst with dramatic increase of serum carbohydrate antigen 199: a three-year follow-up study.
abstract: BACKGROUND
  Tumor markers are widely applied in clinical practice, however, few serum markers have been found for intracranial tumors. Herein, we firstly report an intracranial epidermoid cyst case with extremely high level of serum CA 199. Furthermore, the relationship between CA 199 level and intracranial epidermoid cyst was closely followed for a long period.
  
  
  METHODS
  We report a case of 41-year-old man with a history of 2 months' headache and sudden exacerbation for 3 days. Radiology examination suggested multiple lesions spreading along ventricular system. Laboratory tests showed exceeding increase of serum CA 199. The patient underwent craniotomy and continuous lumber drainage. Post-operative pathology proved a ruptured intracranial epidermoid cyst. MRI scans and serum CA 199 were closely followed up for three years.
  
  
  CONCLUSIONS
  This case suggests an important role of serum CA 199 in the diagnosis and follow-up of intracranial epidermoid cyst. Ruptured intracranial epidermoid cyst should be considered for a sudden onset case with multiple intracranial lesions and dramatically increased serum CA 199.
authors.affiliation: Department of Neurosurgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang Province, P. R. China. ywisyw@gmail.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Yan
authors.affiliation: Department of Neurosurgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang Province, P. R. China. maxalive@163.com.
authors.forename: Liang
authors.initials: L
authors.lastname: Xu
authors.affiliation: Department of Neurosurgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang Province, P. R. China. wuqun30639@sina.com.
authors.forename: Qun
authors.initials: Q
authors.lastname: Wu
authors.affiliation: Department of Neurosurgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang Province, P. R. China. d.chengao@zju.edu.cn.
authors.forename: Gao
authors.initials: G
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang Province, P. R. China. zjm135@vip.sina.com.
authors.forename: Jian-Min
authors.initials: JM
authors.lastname: Zhang
authors.affiliation: Department of Pathology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang Province, P. R. China. autumn200327@aliyun.com.
authors.forename: Shu-Mei
authors.initials: SM
authors.lastname: Wei
authors.affiliation: Department of Neurosurgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang Province, P. R. China. richardwang_2327@sina.com.
authors.forename: Yong-Jie
authors.initials: YJ
authors.lastname: Wang
mesh_terms: D000328:Adult; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000097:blood*; D001932:Brain Neoplasms / Q000097:blood / Q000175:diagnosis / Q000000981:diagnostic imaging; D058565:Cerebral Ventriculitis / Q000097:blood / Q000175:diagnosis / Q000000981:diagnostic imaging; D004814:Epidermal Cyst / Q000097:blood / Q000175:diagnosis / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011859:Radiography; D012422:Rupture, Spontaneous
chemical_list: D015295:Antigens, Tumor-Associated, Carbohydrate; C578959:carbohydrate antigen 199, human