Alhasan Samer, Alzafiri Azeez, Tharwat Hisham, Alhasan Ramia, Alrashidi Nadia
Internal Medicine, New Jahra Hospital, Al Jahra, KWT.
Internal Medicine, Al Jahra Hospital, Al Jahra, KWT.
Cureus. 2025 Aug 4;17(8):e89341. doi: 10.7759/cureus.89341. eCollection 2025 Aug.
Carcinoembryonic antigen (CEA) is a commonly used tumor marker, primarily for the surveillance of colorectal and other gastrointestinal malignancies. However, its diagnostic specificity is limited, as CEA levels may be elevated in several benign conditions. This case report aims to highlight the potential diagnostic confusion and psychological distress caused by incidental CEA elevation in asymptomatic individuals when tested outside of an appropriate clinical context. We describe the case of a 39-year-old Kuwaiti woman who underwent a routine health check-up at a private laboratory, during which CEA was measured despite the absence of cancer-related symptoms. Her CEA level was markedly elevated, prompting anxiety and a cascade of investigations. Clinical history, physical examination, laboratory testing, endoscopic procedures, and imaging were employed to determine the cause of elevation. The patient's elevated CEA level (49.02 ng/mL) was not associated with any detectable malignancy. Her past medical history included a laparoscopic sleeve gastrectomy a year earlier. Clinical assessment revealed chronic dyspepsia, anemia, and right upper quadrant tenderness. A comprehensive workup, including colonoscopy, upper gastrointestinal (GI) endoscopy, and contrast-enhanced CT imaging excluded neoplastic processes. Abdominal ultrasound revealed chronic calculous cholecystitis. Following laparoscopic cholecystectomy, her symptoms improved and repeat CEA levels normalized, confirming a benign inflammatory etiology. This case illustrates the limitations of CEA as a screening tool and the importance of interpreting tumor markers within the appropriate clinical context. Routine ordering of tumor markers in asymptomatic patients can result in unnecessary anxiety, diagnostic delays, and resource use. Clinicians should rely on symptom-guided evaluations rather than indiscriminate testing.
癌胚抗原（CEA）是一种常用的肿瘤标志物，主要用于监测结直肠癌和其他胃肠道恶性肿瘤。然而，其诊断特异性有限，因为在几种良性疾病中CEA水平可能会升高。本病例报告旨在强调在适当临床背景之外对无症状个体进行检测时，偶然出现的CEA升高可能导致的潜在诊断困惑和心理困扰。我们描述了一名39岁科威特女性的病例，她在一家私人实验室进行常规健康检查，尽管没有癌症相关症状，但仍检测了CEA。她的CEA水平显著升高，引发了焦虑并进行了一系列检查。通过临床病史、体格检查、实验室检测、内镜检查和影像学检查来确定升高的原因。患者升高的CEA水平（49.02 ng/mL）与任何可检测到的恶性肿瘤均无关。她的既往病史包括一年前进行的腹腔镜袖状胃切除术。临床评估显示有慢性消化不良、贫血和右上腹压痛。包括结肠镜检查、上消化道内镜检查和增强CT成像在内的全面检查排除了肿瘤性病变。腹部超声显示慢性结石性胆囊炎。腹腔镜胆囊切除术后，她的症状改善，复查CEA水平恢复正常，证实为良性炎症病因。本病例说明了CEA作为筛查工具的局限性以及在适当临床背景下解读肿瘤标志物的重要性。对无症状患者常规开具肿瘤标志物检查可能会导致不必要的焦虑、诊断延迟和资源浪费。临床医生应依靠症状引导的评估，而不是不加区分地进行检测。
