A Case of the Rupture of CA19-9 Producing Huge Splenic Cyst

Kazuaki Kobayashi, Satoshi Suzuki, Takeshi Mishina, Masahiro Ootaki, Kouei Nihei and Youichi Matsubara

Department of Surgery, Tsuruoka Municipal Shonai Hospital

We report a case of the rupture of a huge CA19-9 producing splenic cyst. A 39-year-old woman admitted for left side abdominal pain, was found in computed tomography to have a 15×9 cm-splenic cyst, occupying almost of the spleen surrounded by ascites. She also had high serum CA19-9 of 7,490 U/ml . We suspected peritonitis due to splenic cyst rupture, and conducted splenectomy. The inner surface of the splenic cyst was white, irregular, and mesh-liked, covered with stratified squamous epithelium. The cystic fluid and ascites were brown. CA19-9 in cystic fluid was high at 711,000 U/ml. The cyst was found histologically to be epithelial and immunohistochemical staining was positive for CA19-9 in cystic fluid. After surgery, serum CA19-9 returned to the normal range. Upper and lower gastrointestinal endoscopy showed no further abnormality.

Key words
splenic cyst, CA19-9, rupture

Reprint requests
Kazuaki Kobayashi Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences
1-757 Asahimachi-dori, Niigata, 951-8510 JAPAN

Accepted
May 21, 2008

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