Extremely high values of CA 19-9 in liver hydatidosis and frank biliary rupture

Ramia, José Manuel; Plaza, Roberto de la; Sampedro, José E. Quiñones; Veguillas, Pilar; García-Parreño, Jorge

doi:10.4318/tjg.2011.0272

Cited by 4 publications

(3 citation statements)

References 9 publications

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“…However, it is neither a very specific nor sensitive marker, and increased levels of CA19-9 have been described in other malignancies, including lung cancers and malignant pleural effusions (2-6). Raised levels of CA 19-9 have been described in a host of benign conditions involving various organ systems such as the hepatobiliary, respiratory, genitourinary and endocrine systems and in rheumatic diseases (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). The benign causes of raised CA 19-9 levels are summarised in Table.…”

Section: Discussionmentioning

confidence: 99%

Elevated CA 19-9 Levels Observed in Association with a Pulmonary Neuroendocrine Tumour and Amyloid

Faruqi

Gumparthy²,

Wahbi³

2013

Intern. Med.

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Investigations completed in a 77-year-old ex-smoker presenting with weight loss showed raised CA 19-9 levels. The findings of chest radiograph, abdominal computed tomography (CT) and gastrointestinal endoscopic examinations were all normal. On follow-up, the patient developed left upper lobe collapse on chest radiograph with increasing CA 19-9 levels. Chest CT findings suggested the presence of a left upper lobe tumour. The results of a biopsy of the left upper lobe nodule seen on bronchoscopy suggested a diagnosis of amyloidosis; however, this was not the only diagnosis. The left upper lobe mass comprised a neuroendocrine tumour with amyloid deposition just beneath the bronchial epithelium and focally between the nests of the tumour cells. We report and discuss this uncommon association and presentation. Case ReportA 77-year-old woman who was an ex-smoker of 40 packyears presented with complaints of weight loss and a decreased appetite. She was known to have mild diverticular disease and experienced a disease flare up with an increased stool frequency of 2-3 bowel movements/day on admission. There was no history of haematochezia, malena, cough, expectoration or haemoptysis. She was known to have bronchial asthma and was receiving treatment with inhaled corticosteroids. On examination, she was not found to have any pallor, clubbing or lymphadenopathy. She had a body mass index of 16. Her heart rate was 80 beats/min and her blood pressure was 130/80 mmHg. The findings of a systemic examination were normal.The initial diagnoses considered included malignancy (possibly gastrointestinal), mal-absorption syndrome and thyroid dysfunction, and investigations were accordingly organised. Other than a serum albumin level of 2.7 g/dL, the patient's biochemical profile was normal. Liver function tests were within the normal range and showed a bilirubin level of 16 umol/L, an alkaline phosphatase level of 92 IU/L and an alanine aminotransferase level of 29 IU/L. A full blood count and thyroid function tests were normal. Chest radiograph findings were normal. Sigmoidoscopy and colonoscopy results were normal other than showing mild diverticular disease. Oesophagogastroduodenoscopy findings were normal, as was the subsequent report of a duodenal biopsy. Tumour marker tests showed that the levels of Carbohydrate Antigen 19-9 (CA 19-9) were raised at 300 ku/L (normal <40 ku/L). The tests were subsequently repeated, and the CA 19-9 level was found to be 326 ku/L. The Carcinoembryonic Antigen, Alpha-fetoprotein and Cancer Antigen 125 levels were normal. Ultrasound and subsequent computed tomography (CT) of the abdomen and pelvis were normal. The diarrhoea resolved, and the patient was feeling better. A dietary opinion was sought, and the patient was started on nutritional supplements. She was discharged three weeks from admission, as nothing specific was found, with plans to follow up with repeat CA 19-9 level measurements.Two months after discharge the patient was again admitted, as her symptoms of anorexia and weight lo...

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Section: Discussionmentioning

confidence: 99%

Elevated CA 19-9 Levels Observed in Association with a Pulmonary Neuroendocrine Tumour and Amyloid

Faruqi

Gumparthy²,

Wahbi³

2013

Intern. Med.

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“…Simultaneous involvement of both organs maybe encountered in 5% -13% of cases [2] [5]. Despite predilection to these organs, HC may potentially occur at any site of the body, including the brain, heart, kidneys, ureter, spleen, uterus, fallopian tubes, mesentery, pancreas, diaphragm and muscles [7]. In fact, 14% -19% of intra-abdominal HCs are extra-hepatic.…”

Section: Discussionmentioning

confidence: 99%

“…Three types of cyst rupture have been described in the literature: 1) contained rupture of an endocyst with an intact pericyst resulting in a membrane-like appearance of the collapsed endocyst on imaging; 2) communicating rupture with leakage of cyst contents into the biliary or bronchial tree, which is also the most frequently encountered type of rupture; 3) direct rupture usually involving the pericyst and endocyst with free spillage of cyst content into the pleural or peritoneal space [7] [8]. Peritoneal leakage may result in dissemination of the disease.…”

Section: Discussionmentioning

confidence: 99%

Fatal Rupture of a Giant Hydatid Cyst in an Elderly Patient

Altıntop¹,

Yılmaz²,

Alincak³

et al. 2016

OJEM

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Hydatid cyst (HC) disease, which is endemic in Turkey, is mainly located in the liver. Cyst rupture is the most common complication of HC. Ultrasonography (US) and computerized tomography (CT) are the main diagnostic modalities for HC disease. Presented herein was a case of an elderly female patient who died shortly after presenting to the emergency department with severe abdominal pain. A giant HC was detected on initial evaluation by US. However, the presence of significant amounts of free fluid in the peritoneal space following a CT of the abdomen. The patient died despite medical and surgical intervention.

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Rapid decline to normal levels of extraordinarily elevated CA 19-9 after Giardiasis

Ergül¹,

Doğan²,

Sarıkaya³

et al. 2013

Clinics and Research in Hepatology and Gastroenterology

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Extremely high values of CA 19-9 in liver hydatidosis and frank biliary rupture

Abstract: Benign safra yolu hastal›¤› olan ikterli vakalarda karbonhidrat antijen 19-

Cited by 4 publications

References 9 publications

Elevated CA 19-9 Levels Observed in Association with a Pulmonary Neuroendocrine Tumour and Amyloid

Elevated CA 19-9 Levels Observed in Association with a Pulmonary Neuroendocrine Tumour and Amyloid

Fatal Rupture of a Giant Hydatid Cyst in an Elderly Patient

Rapid decline to normal levels of extraordinarily elevated CA 19-9 after Giardiasis

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