A Resected Case of a CA19-9 Producing Mucinous Cystadenoma of the Appendix

Masanori Kishinaka, Shinji Momii, Takashi Ohsato, Masahisa Tabata

Division of Surgery, Higashikunisaki Municipal General Hospital

We experienced a case, which underwent an appendectomy including part of the cecum because of mucinous cystadenoma of the appendix producing CA19-9. A 68-year-old woman was admitted to our hospital for right lower abdominal pain and a palpable tumor. Since the tumor size was 5 cm and the serum CA19-9 level was high, abdominal echography, barium enema examination, and abdominal CT scan were performed. Since the tumor was diagnosed as an appendicular mucocele from these studies, appendectomy including a part of the cecum was performed. The appendix was expanded and contained abundant yellow mucin. The mucin contained 11440 U of CA19-9 per ml. The mucosa of the appendix was almost deciduated and the remaining epithelium was organized in columnar cells indicating no malignant change. Histological findings were consistent with mucinous cystadenoma of the appendix. Immunohistological staining revealed that epithelial cell scontained granules of CA19-9. The serum level of CA19-9 was decreaed to the normal range soon after the operation. Mucinous cystadenoma cells of the appendix were presumed to produce the CA19-9. To diagnose the malignancy of the appendicular mucocele, the colonoscopy was needed and the serum level of CA19-9 could not exclude it.

Key words
mucinous cystadenoma of the appendix, CA19-9 producing appendicular tumor, myxoglobulosis of the appendix

Reprint requests
Masanori Kishinaka Division of Surgery, Higashikunisaki Municipal General Hospital
1456 Shimobaru, Aki-machi, Higashikunisaki-gun, 873-02 JAPAN

Accepted
June 11, 1997

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