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  • Title: Gallbladder mass with a carbohydrate antigen 19-9 level in the thousands: malignant or benign pathology? Report of a case.
    Author: Clarke T, Matsuoka L, Jabbour N, Mateo R, Genyk Y, Selby R, Gagandeep S.
    Journal: Surg Today; 2007; 37(4):342-4. PubMed ID: 17387571.
    Abstract:
    Tumor markers such as carbohydrate antigen 19-9 (CA 19-9) are commonly measured in the serum of patients with suspected pancreaticobiliary malignancies. Moderate elevations of CA 19-9 may be seen in benign disease, but levels in the thousands are indicative of malignancy. We report the case of a 64-year-old man with an elevated CA 19-9 of 5791 U/ml and radiological findings suggestive of metastatic gallbladder carcinoma. The patient underwent cholecystectomy and excision of a common bile duct stricture, with hepaticojejunostomy and liver biopsy. The final surgical pathology was consistent with xanthogranulomatous cholecystitis (XGC) and the elevated CA 19-9 returned to normal postoperatively. Thus, an elevated CA 19-9 level, even in the thousands, should not preclude patients from an operation if a mass is deemed resectable. Thorough investigation and treatment may result in a curative operation even if unresectable malignant disease is initially suspected.
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