Splenic cyst causing high levels of pathognomonic CA 19-9: A case report

Öz

Cancer antigen 19-9 is a tumor marker present at high levels in the bile duct, colorectal, gastric, and hepatocellular cancer than esophagus or pancreas cancer. It is used to confirm the diagnosis of pancreas cancer, to assess the clinical response to the treatment, and to evaluate the recurrence of pancreatic cancer. High levels can also be seen in benign conditions, such as biliary tract obstruction, cholangitis, inflammatory bowel disease, acute or chronic pancreatitis, liver cirrhosis, cystic fibrosis, or thyroid diseases. Another rare condition which is associated with the high level of cancer antigen 19-9 is the splenic cyst. Hence, we are submitting this case report of splenic cyst because of its rareness and similarities to previously published cases with high levels of cancer antigen 19-9.

Anahtar Kelimeler

• CA 19-9,pancreas,splenic cyst

Patognomonik CA 19-9 yüksekliğine sebep olan dalak kisti olgusu

Öz

CA 19-9 safra kanalı, kolon, mide, over, hepatosellüler, özofagus ve pankreas kanserleri gibi malign durumlarda yüksek seviyelerde görülebilen bir tümör göstergesidir. Pankreas kanseri ayırıcı tanısı ve yine pankreas kanserinde tedaviye cevap ve nüksün değerlendirilmesinde kullanılır. Yüksek seviyeler safra yolu obstrüksiyonu, kolanjit, inflamatuvar barsak hastalığı, akut veya kronik pankreatit, karaciğer sirozu, kistik fibrozis ve tiroid hastalıkları gibi benign durumlarda da görülebilir. CA 19- yüksekliği ile birlikte olan nadir bir durum da dalak kistleridir. Olgumuz nadir olması ve CA 19-9‘un yayınlanılan benzer olgulardan yüksek seviyelerde olması sebebiyle sunulmuştur.

Anahtar Kelimeler

• CA 19-9,pankreas,splenik kist

Kaynakça

1. 1. Steinberg W. The clinical utility of the CA 19-9 tumor-associated antigen. Am J Gastroenterol 1990;85:350-5. 2. Goonetilleke KS, Siriwardena AK. Systematic review of carbohydrate antigen (CA 19-9) as a biochemical marker in the diagnosis of pancreatic cancer Eur J Surg Oncol 2007;33:266-70. 3. Boone BA, Steve J, Zenati MS, et al. Serum CA 19-9 response to neoadjuvant therapy is associated with outcome in pancreatic adenocarcinoma. Ann Surg Oncol 2014;21:4351-8. 4. Ito S, Gejyo F. Elevation of serum CA19-9 levels in benign diseases. Intern Med 1999;38:840-1. 5. Tempero MA, Uchida E, Takasaki H, et al. Relationship of carbohydrate antigen 19-9 and Lewis antigens in pancreatic cancer. Cancer Res 1987;47:5501-3. 6. Matsumoto S, Mori T, Miyoshi J, et al. Huge splenic epidermoid cyst with elevation of serum CA19-9 level. J Med Invest 2015;62: 89-92. 7. Goonetilleke KS, Siriwardena AK. Systematic review of carbohydrate antigen (CA 19-9) as a biochemical marker in the diagnosis of pancreatic cancer. Eur J Surg Oncol 2007;33:266-70. 8. Terada T, Yasoshima M, Yoshimitsu Y, Nakanuma Y. Carbohydrate antigen 19-9 producing giant epithelial cyst of the spleen in a young woman. J Clin Gastroenterol 1994;18:57-61. 9. Urban D, Catane R. Serum tumor markers in oncology. IMAJ Isr Med Assoc J 2009;11:103-4. 10. Brauner E, Person B, Ben-Ishay O, Kluger Y. Huge splenic cyst with high level of CA 19 -9: the rule or the exception? Isr Med Assoc J 2012;14:710-1. 11. Hansen MB, Moller AC. Splenic cysts. Surg Laparosc Endosc Percutan Tech 2004;14:316-22. 12. van Lacum MW, Hessels RA, Kremer GD, Jaspers CA . A splenic cyst and a high serum CA 19-9: a case report. Eur J Intern Med 2000;11:104-7.