A case of a jejunal gastrointestinal stromal tumor with significantly elevated CA19-9 levels. (2020)

• Record Type: Journal Article
• Authors: Mohri, Koichi; Hiramatsu, Kazuhiro; Shibata, Yoshihisa; Aoba, Taro; Fujii, Masahiro; Arimoto, Atsuki; Ito, Akira; Kato, Takehito
• Is Part Of: International journal of surgery case reports. Volume 72(2020)
• Page Start: 569
• Page End: 571
• Publication Date: 2020
• Subjects: GIST gastrointestinal stromal tumor -- CA19-9 carbohydrate antigen 19-9 -- CT computed tomography -- CEA carcinoembryonic antigen; Tumor marker -- Carbohydrate antigen 19-9 -- Gastrointestinal stromal tumour; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2020.06.018
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: We report a jejunal GIST with elevated CA19-9 levels that normalized after resection. A correlation between GIST and the elevation of CA19-9 has been unknown. The mechanism might be inflammatory hypersecretion by normal epithelial cells. Careful interpretation of elevated CA19-9 is mandatory. The possible surgical procedures should not be limited to a minimally-invasive approach. Abstract: Introduction: A gastrointestinal stromal tumor (GIST) with an elevated serum tumor marker level is very rare. We report a case of jejunal GIST associated with extremely elevated levels of serum carbohydrate antigen 19-9 (CA19-9). Presentation of case: A 61-year-old woman was referred to our hospital for examination of an abdominal tumor. Laboratory tests revealed extremely elevated CA19-9 levels (13, 498 U/mL). Enhanced abdominal computed tomography demonstrated a well-enhanced, round 40 mm tumor. The patient underwent a jejunectomy and lymph node dissection. Based on the postoperative pathological findings, the tumor was diagnosed as a GIST. Microscopically, a solid region of the resected tumor showed negative staining for CA19-9. The serum CA19-9 level drastically decreased postoperatively. Discussion: Increased proliferation of epithelial cells secondary to inflammation and ulceration of epithelia may lead to increased secretion and accumulation of CA19-9, which is consequently released into the blood circulation. Conclusion: In cases of GIST, an isolated increase of serum CA19–9 is extremely rare; but they are not necessarily associated with malignant transformation.