Pulmonary Sequestration: An Unusual Cause of Elevated CA 19-9

Liu, Kao–Lang; Chen, Jin‐Shing; Cheng, Tsu‐Yao

doi:10.1038/ajg.2016.142

Cited by 2 publications

(1 citation statement)

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“…Herein, we report six cases of patients with AIP, causing the elevation of CA 19-9 ranging from 1950 U/mL to 12,000 U/mL, and a case of a patient with liver steatosis and an increased CA 19-9 value to 1930 U/mL. When considering differential diagnosis due to the low specificity of tumor markers and lack of obvious radiological image, various diseases should be taken into consideration [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 68 , 69 ]; however, a mildly increased dimension of the pancreas in MRI with areas of fluid signals could correspond to past AIP that induced increased CA 19-9. According to the literature, about 25% of patients with AIP show values of CA 19-9 > 37 U/mL, and only around 12.2% of them show elevated levels > 100 U/mL [ 70 ].…”

Section: Discussionmentioning

confidence: 99%

Significantly Elevated CA 19-9 after COVID-19 Vaccination and Literature Review of Non-Cancerous Cases with CA 19-9 > 1000 U/mL

Ciesielka,

Jakimów,

Tekiela

et al. 2024

JCM

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Background: CA 19-9 is a commonly assessed tumor marker, considered characteristic of pancreatic ductal adenocarcinoma (PDAC) and biliary tract cancers; however, the positive predictive value of CA 19.9 is too low, and the usage of CA 19.9 as a screening tool in the healthy population remains controversial. Methods: The presented case illustrates a reversed diagnosis of highly elevated serum CA 19-9 levels in a 54-year-old female complaining of pain in the epigastric region, shortly after COVID-19 vaccination. Laboratory tests showed a significantly elevated level of the CA 19-9 marker (>12,000 U/mL, reference value: <37 U/mL) with normal pancreatic enzyme activity. The patient underwent imaging examination, which showed no abnormalities, except for increased pancreatic dimension and areas of fluid signal in the pancreas in magnetic resonance imaging (MRI), which may correspond to autoimmune pancreatitis (AIP). The patient remains asymptomatic with a recommendation for a follow-up MRI in 12 months. Results: A literature review conducted revealed multi-causal CA 19-9 increases above 1000 U/mL, including non-cancerous diseases of the lung, pancreas, liver, ovary, kidney, and others. The median concentration of CA 19-9 regardless of the cause of disease was 2810 U/mL (IQR ± 6895). The median CA 19-9 values in men and women were 3500 (IQR ± 10,050) and 2455 (IQR ± 3927), respectively, and differ significantly between the compared groups (p < 0.05). There was no difference between CA 19-9 values and the categorized cause of the increase. Conclusions: Conducting differential diagnosis, it should not be forgotten that most international guidelines recommend the use of CA 19-9 only in conjunction with pathology of pancreas in radiological imaging; however, even such a combination can point the diagnostic pathway in the wrong direction. A highly elevated CA 19-9 level, typically associated with PDAC, may be the result of benign disease including AIP related to COVID-19 vaccination.

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Section: Discussionmentioning

confidence: 99%

Significantly Elevated CA 19-9 after COVID-19 Vaccination and Literature Review of Non-Cancerous Cases with CA 19-9 > 1000 U/mL

Ciesielka,

Jakimów,

Tekiela

et al. 2024

JCM

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Extralobar pulmonary sequestration with elevated serum neuron-specific enolase

et al. 2020

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Rationale: Pulmonary sequestration (PS) presenting with elevated serum tumor markers is rare, and it might be misdiagnosed as malignancy. Patient concerns: A 26-year-old asymptomatic male patient was admitted because the x-ray showed an intrathoracic lesion. Meanwhile, the serum neuron-specific enolase (NSE) was elevated. Three-dimensional computed tomography angiography revealed an isolated feeding vessel arising from the aorta. Diagnoses: Extralobular PS was confirmed by computed tomography angiography and postoperative pathological staining. Interventions: Two-port thoracoscopic resection of the sequestrated lobe was performed. Outcomes: The serum NSE decreased to within the normal range and persisted during the follow up of 10 months. Lessons: A thorough work-up should be considered for the PS patients presenting with abnormal serum NSE. Detailed knowledge regarding the relationship between NSE and PS necessitates further studies.

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Pulmonary Sequestration: An Unusual Cause of Elevated CA 19-9

Cited by 2 publications

References 0 publications

Significantly Elevated CA 19-9 after COVID-19 Vaccination and Literature Review of Non-Cancerous Cases with CA 19-9 > 1000 U/mL

Significantly Elevated CA 19-9 after COVID-19 Vaccination and Literature Review of Non-Cancerous Cases with CA 19-9 > 1000 U/mL

Extralobar pulmonary sequestration with elevated serum neuron-specific enolase

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