Two Patients with Extremely Elevated Tumor Markers: Where Is the Malignancy?

Author:

van der Veek Patrick P. J.1,de Vos tot Nederveen Cappel Wouter H.2,Langers Alexandra M. J.3ORCID,van Hoek Bart3

Affiliation:

1. Departments of Internal Medicine, Gastroenterology, and Hepatology, Medisch Centrum Haaglanden, P.O. Box 432, 2501 CK The Hague, The Netherlands

2. Department of Gastroenterology and Hepatology, Isala Clinics, P.O. Box 10500, 8000 GM Zwolle, The Netherlands

3. Department of Gastroenterology and Hepatology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands

Abstract

Serum tumor markers are useful to evaluate a cancer's response to treatment, for early detection of cancer relapse, and, in some cases, to diagnose malignancy. In this paper, we present two patients with significantly elevated serum tumor markerswithoutevidence of malignant disease. An 18-year-old patient suffering from autoimmune hepatitis had markedly increased alpha-fetoprotein (aFP) levels (2,002 μg/L; normal <10 ug/L). Extensive imaging showed no signs of hepatocellular carcinoma or other cancer, and treatment with Prednisone led to rapid normalization of both liver enzymes and aFP. The second patient, a 60-year-old female with painless jaundice due to biliary stone disease, had very high serum levels of CA19-9 (18,000 kU/L, normal <27 kU/L). Liver biochemistry and serum CA19-9 concentration decreased to almost normal values (45 kU/L) after biliary stenting. These cases demonstrate that serum tumor markers can be elevated in benign disease and are therefore not appropriate to diagnose cancer.

Publisher

Hindawi Limited

Subject

Gastroenterology,Hepatology

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