A case of elevated carbohydrate antigen 19-9 with a benign cause

Authors

  • Jayesh V. Parikh Department of General Surgery, B J Medical college and Civil hospital, Ahmedabad, Gujarat, India
  • Parth R. Dalal Department of General Surgery, B J Medical college and Civil hospital, Ahmedabad, Gujarat, India
  • Piyush N. Baraiya Department of General Surgery, B J Medical college and Civil hospital, Ahmedabad, Gujarat, India
  • Sachin R. Vishwakarma Department of General Surgery, B J Medical college and Civil hospital, Ahmedabad, Gujarat, India

DOI:

https://doi.org/10.18203/2349-2902.isj20205384

Keywords:

Carbohydrate antigen 19-9, Hepatobiliary malignancy, Cholecystitis, Gall bladder perforation, Cholangitis

Abstract

Serum carbohydrate antigen 19-9 (CA 19-9), a marker of malignant tumors, is generally slightly elevated in benign conditions. We report a case of cholecystitis with perforated gall bladder with significantly elevated level of serum CA 19-9 based on abdomen computed tomography and intra operative findings. A 70 years diabetic and hypertensive female presented with right hypochondriac pain associated with occasional itching and nausea without vomiting with markedly raised CA 19-9 (1554 U/ml) with CECT abdomen suggestive of perforated gall bladder with cholecystitis.  Patient electively operated for open cholecystectomy and per operative findings were distended gall bladder with multiple calculi within with edematous gall bladder wall and adhesions between gall bladder and omentum and colon. Gall bladder removed and biopsy suggestive of chronic calculus cholecystitis. On post-operative day 5th and 7th CA 19-9 was repeated twice and drastic fall to 5 U/ml and 12 U/ml respectively. Chronic calculus cholecystitis with high elevation of CA 19-9 is rare.

References

Yaman E, Coskun U, Buyukberber S, Ozturk B, Kaya AO, Yildiz R, et al. Persistent elevation of CA 19-9 in an apparently-healthy 56-year-old woman. Laborat Medic. 2007;38(8):485-6.

Shah N, Tetangco E, Arshad HM, Raddawi H. Mirrizi Syndrome and markedly elevated levels of carbohydrate antigen 19-9 in the absence of malignant disease. Cas Repo Gastrointest Medic. 2017;2017.

Ballehaninna UK, Chamberlain RS. The clinical utility of serum CA 19-9 in the diagnosis, prognosis and management of pancreatic adenocarcinoma: An evidence-based appraisal. J Gastrointest Oncol. 2012;3(2):105.

Kim S, Park BK, Seo JH, Choi J, Choi JW, Lee CK, et al. Carbohydrate antigen 19-9 elevation without evidence of malignant or pancreatobiliary diseases. Scientific Reports. 2020;10(1):1-9.

Downloads

Published

2020-11-27

Issue

Section

Case Reports