Delayed radiation-induced inflammation accompanying a marked carbohydrate antigen 19-9 elevation in a patient with resected pancreatic cancer.
Although carbohydrate antigen (CA) 19-9 is a useful tumor marker for pancreatic cancer, it can also become elevated from a variety of benign and malignant conditions. Herein we describe an unusual presentation of elevated CA 19-9 in an asymptomatic patient who had previously undergone adjuvant chemotherapy and radiation therapy for resected early stage pancreatic cancer. The rise in CA 19-9 might be due to delayed radiation-induced inflammation related to previous intra-abdominal radiation therapy with or without radiation recall induced by gemcitabine. After treatment with corticosteroids the CA 19-9 level decreased to normal, and the patient has not developed any evidence of recurrent cancer to date.
Department of Radiation Oncology, West Virginia University School of Medicine, Morgantown, WV, USA.
Malcolm D
MD
Mattes
Department of Surgery, West Virginia University School of Medicine, Morgantown, WV, USA.
Jon S
JS
Cardinal
Department of Radiation Oncology, West Virginia University School of Medicine, Morgantown, WV, USA.
Geraldine M
GM
Jacobson
Biologic tumor marker; CA 19-9 antigen; Pancreatic cancer; Radiation recall reaction; Radiation therapy