A Case of Large Liver Cyst with Extraordinally High Level of
CA19-9 in the Serum, CA19-9 and CEA in the Cystic Fluid

Katsunori Matsuzawa, Kouichi Itabashi, Shingo Matsuzawa¹⁾, Osamu Tsutsumi²⁾, Yoshiki Hiki²⁾ and Akira Kakita²⁾

Department of Surgery, Kojirakawa Shiseidou Hospital
¹⁾Department of Surgery, Shiseidou General Hospital
²⁾Department of Surgery, Kitasato University School of Medicine

The patient was 68-year-old woman. The abdominal echograms and CT scans revealed a large cyst in the left lobe of the liver. The CA19-9 showed a high level of 356U/ml in the serum. Three weeks later, the level increased 565U/ml. We believe that the high serum level of CA19-9 was due to the large liver cyst since we could not find any other foci such as pancreatic or gastrointentinal disease. Percutaneous cystic needle aspiration showed serous fluid with extremely high levels of CA19-9 of 2400,000U/ml and CEA of 2,438ng/ml. The result of cytological examination proved benign. The serum showed a normal level of 18.3U/ml two weeks after the left hepatic lobectomy. The result of histological examination of the cyst proved benign. Localization of the CA19-9 and CEA was positive in immunohistochemical staining of the epithelium of the cyst wall. We conclude that high levels of tumor markers in the serum do not necessarily indicate malignant change. This case showed quite a rare large liver cyst with abnormally high levels of CA19-9 in the serum and CEA in the fluid.

Key words
large liver cyst, CA19-9, CEA

Reprint requests
Katsunori Matsuzawa Department of Surgery, Kojirakawa Shiseidou Hospital 1-12-26 Higashiharamachi, Yamagata, 990-0034 JAPAN

Accepted
May 25, 1999

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