We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
pancreatic mass and extreme elevation of CA 19–9: a benign masquerade of cholangiocarcinoma.
- Authors
Hall, Catherine; McLaren, Mairi; Mosse, Charles
- Abstract
Carbohydrate antigen 19–9 (CA 19–9) is a specific tumour marker for pancreato-biliary malignancy. Immunoglobulin G4-related disease (IgG4-RD) is an immune-mediated condition in which IgG4 deposits infiltrate various organs, including the biliary tract manifesting IgG4 sclerosing cholangitis and pseudotumours. An 83-year-old woman presented with severe obstructive jaundice, weight loss and an extreme elevation of CA 19–9 level of 3295 kU/L. Magnetic resonance cholangiopancreatography (MRCP) revealed a pancreatic mass amputating the biliary tree. Liver function tests revealed a cholestatic pattern and severe hyperbilirubinaemia (289umol/L). IgG4 level was found to be high at 7.97 g/L. After treatment with high-dose corticosteroids, repeat MRCP 2 months later revealed disappearance of the pancreatic mass. There was also normalization of the bilirubin and a dramatic decrease of CA 19–9. This case reports the highest published benign elevation of Ca19.9 level in the setting of IgG4 disease. Differentiation between cholangiocarcinoma and IgG4-RD is important, as the treatment is vastly different.
- Subjects
CHOLANGIOCARCINOMA; BILIARY tract; LIVER function tests; TUMOR markers; CHOLANGITIS; MAGNETIC resonance; OBSTRUCTIVE jaundice
- Publication
Journal of Surgical Case Reports, 2022, Vol 2022, Issue 2, p1
- ISSN
2042-8812
- Publication type
Case Study
- DOI
10.1093/jscr/rjac018