Abstract
a case of mucinous biliary cystadenoma with mesenchymal stroma (CMS tumor) in a 64-year-old woman is reported. The patient presented with acute abdominal pain and a palpable mass in the upper abdomen. Computed tomography and abdominal sonography showed characteristic multilocular cysts in the left lobe of the liver. Serum CA 19-9 was elevated to 108 U/ml with normal carcinoembryonic antigen (CEA) and alpha-fetoprotein (AFP) levels. The levels of CA 19-9 and CEA in the cystic fluid were high at 7430 U/ml and 576ng/ml, respectively. The serum CA 19-9 returned to 35 U/ml 4 weeks after tumor resection. These corresponding findings of both tumor markers in the serum and cystic fluid imply that (1) CA 19-9 and CEA both exist in the epithelial component of CMS tumors as evidenced by immunohistochemical stain, (2) serum CA 19-9 is a valuable marker in the diagnosis and monitoring of CMS, and (3) in cystic fluid, there are more significantly high levels of CA 19-9 in CMS compared with levels in simple cyst and polycystic liver disease. Therefore, measurement of CA 19-9 in cystic fluid and serum may be helpful in the differential diagnosis of hepatic cystic lesions.
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References
Carroll BA. Biliary cystadenoma and cystadenocarcinoma: Gray scale ultrasound appearance. JCU 1978;5:337–340.
Ishak K, Willis GW, Cummins SD, Bullock AA. Biliary cystadenoma and cystadenocarcinoma. Cancer 1977;39:322–338.
Marsh JL, Dahms B, Longmire WP Jr. Cystadenoma and cystadenocarcinoma of the biliary system. Arch Surg 1974;109:41–43.
Marcial MA, Hauser SC, Cibas ES, Braver J. Dig Dis Sci 1986;8:884–888.
Hadad AR, Westbrook KC, Graham GG, et al. Synptomatic non-parasitic liver cysts. Am J Surg 1977;134:739–744.
Wheeler DA, Edmondson HA. Cystadenoma with mesenchymal stroma (CMS) in the liver and bile ducts. Cancer 1985:56:1434–1445.
Thomas JA, Scriven MW, Puntis MCA, et al. Elevated serum CA 19-9 levels in hepatobiliary cystadenoma with mesenchymal stroma. Cancer 1993;70:1841–1846.
Pinson CW, Munson JL, Rossi RL, et al. Enucleation of intrahepatic biliary cystadenomas. Surg Gynecol Obstet 1989;168:534–537.
Williams JG, Newman BM, Sutphen JL, et al. Hepatobiliary cystadenoma: A rare hepatic tumor in a child. J Ped Surg 1990;12:1250–1252.
Lewis WD, Jenkins RL, rossi RL, et al. Surgical treatment of biliary cystadenoma. Arch Surg 1988;123:563–568.
Akawari OE, Tucker A, Seigler HF, et al. Hepatobiliary cystadenoma with mesenchymal stroma. Ann Surg 1990;211:18–27.
Choi BI, Lim JH, Han MC, et al. Biliary cystadenoma and cystadenocarcinoma: CT and sonographic findings. Radiology 1989;171:57–61.
Korobkin M, Stephens DH, Lee JKT, et al. AJR 1989;153:507–511.
Genkins SM, Tucker A, Seigler HF, et al. Biliary cystadenoma with mesenchymal stroma: CT and angiographic appearance. J Comput Assist Tomogr 1988;12:527–529.
Palacios E, Shannon M, Solomon C, et al. Biliary cystadenoma: ultrasound, CT, MRI. Gastrointest Radiol 1990;15:313–316.
Kawashima A, Fishman EK, Hurban RH, et al. Biliary cystadenoma with intratumoral bleeding: Radiological-pathologic correlation. J Comput Assist Tomogr 1991;15:1035–1038.
Iemoto Y, Kondo Y, Nakano T, et al., Biliary cystadenocarcinoma diagnosed by liver biopsy performed under ultrasonographic guidance. Gastroenterology 1983;84:399–403.
Steinberg W. The clinical utility to the CA 19-9 tumor-associated antigeen. Am J Gastroenterol 1990;85:350–355.
Thompson JE, Wolff M. Intrahepatic cystadenoma of bile duct origin, with malignant alteration: Report of a case treated with total left hepatic lobectomy. Milit Med 1965;130:218–224.
Mizumoto R, Kawarada Y, Taoka H. A new classification of cystic malignant tumors of the liver: Classification of 65 cases reported at the 26th Annual Meeting of the Liver Cancer Society of Japan. J Gastroenterol Hepatol 1991;6:400–407.
Takayasu K, Muramatsu T, Moriyama N, et al. Imaging diagnosis of bile duct cystadenocarcinoma. Cancer 1988;61:941–946.
Cheung YK, Chan FL, Leong LLY, et al. Biliary cystadenoma and cystadenocarcinoma: Some unusual features. Clin Radiol 1991;43:183–185.
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Lee, JH., Chen, DR., Pang, SC. et al. Mucinous biliary cystadenoma with mesenchymal stroma: Expressions of CA 19-9 and carcinoembryonic antigen in serum and cystic fluid. J Gastroenterol 31, 732–736 (1996). https://doi.org/10.1007/BF02347626
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DOI: https://doi.org/10.1007/BF02347626