A Case Report of Carbohydrate Antigen 19-9 Producting Carcinoma of Meckel's Diverticulum

Takafumi Oshiro, Tsuneo Tanaka, Toshiyuki Itamoto, Daisuke Tokita, Hiroyuki Yamasaki, Kouichi Oishi, Mari Kimura, Tsuguo Fujitaka, Kazuo Sumimoto and Yasuhiko Fukuda

Department of General Surgery, Hiroshima Prefecural Hospital

A 63-year-old man who complained of melena was admitted to our hospital. The patient was diagnosed with a malignant mesenteric tumor by CT and garium scintigraphy, the rise in CA19-9, and so on. A tumor obvious to the naked eye and thought to be malignant was found during laparotomy for Meckel's diverticulum which was located on the oral side 80 cm from the end of the ileum. The mesenteric tumor, discoverd before the operation, resulted from a swollen lymph node due to metastasis. A partial resection and lymph node dissection were done. Histologically, the tumor was a moderately differentiated adenocarcinoma which developed from the Meckel's diverticulum without ectopic tissues. A serum CA19-9 value decreased rapidly after the operation, and CA19-9 was proved in the tumor cell by immunohistological staining. The adenocarcinoma which developed from the Meckel's diverticulum is very rare, and only 21 cases have been reported in Japan until now. Although reports indicate poor prognosis for this tumor, postoperative recurrence has not been detected in this case for 18 months, and the patient continues to improve. In this patient, the measurement of serum CA19-9 was useful as an indicator of recurrence and as a predictor of metastasis.

Key words
carcinoma of Meckel's diverticulum, carbohydrate antigen 19-9 producting carcinoma

Reprint requests
Takafumi Oshiro Second Department of Surgery, Hiroshima University 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551 JAPAN

Accepted
February 24, 1999

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