Lee J H, Chen D R, Pang S C, Lai Y S
Department of General Surgery and Pathology, China Medical College and Hospital, Taichung, Taiwan.
J Gastroenterol. 1996 Oct;31(5):732-6. doi: 10.1007/BF02347626.
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 576 ng/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.
报告了一例64岁女性的伴有间充质间质的黏液性胆管囊腺瘤（CMS肿瘤）。患者表现为急性腹痛，上腹部可触及肿块。计算机断层扫描和腹部超声显示肝脏左叶有特征性的多房囊肿。血清CA 19-9升高至108 U/ml，癌胚抗原（CEA）和甲胎蛋白（AFP）水平正常。囊液中CA 19-9和CEA水平分别高达7430 U/ml和576 ng/ml。肿瘤切除4周后血清CA 19-9恢复至35 U/ml。血清和囊液中这两种肿瘤标志物的相应结果表明：（1）免疫组化染色证明CA 19-9和CEA均存在于CMS肿瘤的上皮成分中；（2）血清CA 19-9是CMS诊断和监测中的一种有价值的标志物；（3）与单纯囊肿和多囊肝疾病相比，CMS囊液中CA 19-9水平显著更高。因此，检测囊液和血清中的CA 19-9可能有助于肝囊性病变的鉴别诊断。
