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A case of ruptured splenic cyst with elevated serum levels of CEA treated by laparoscopic unroofing
- Source :
- Clinical Journal of Gastroenterology. 12:642-649
- Publication Year :
- 2019
- Publisher :
- Springer Science and Business Media LLC, 2019.
-
Abstract
- Splenic cysts are rare and tend to have elevated tumor markers, of which carbohydrate antigen (CA) 19-9 is the most frequently elevated. Therefore, splenic cysts with elevated serum carcinoembryonic antigen (CEA) levels and without CA19-9 elevation are extremely rare. A 26-year-old woman presented with sudden upper abdominal pain while sleeping. Contrast-enhanced computed tomography (CT) showed an 85-mm simple splenic cyst in the upper pole and a moderate amount of ascites around the spleen. The serum levels of CEA, but not CA19-9, were elevated. Spontaneous rupture of a splenic cyst was diagnosed. We performed elective laparoscopic unroofing. The histological findings revealed a stratified squamous epithelium on the inner surface of the cystic wall. On immunohistochemical examination, the squamous epithelium was found to be positive for cytokeratin (CK)7, negative for calretinin, and positive for CEA. The histological diagnosis was an epidermoid cyst. Three months after the operation, the elevated serum tumor marker levels of CEA were normalized. Splenic cysts with high levels of CEA and low levels of CA19-9 are extremely rare. Laparoscopic unroofing is a useful operative procedure for ruptured splenic cysts with elevated levels of serum tumor markers.
- Subjects :
- Adult
Splenic cyst
Pathology
medicine.medical_specialty
CA-19-9 Antigen
Epidermal Cyst
Spleen
Stratified squamous epithelium
03 medical and health sciences
Cytokeratin
0302 clinical medicine
Carcinoembryonic antigen
Ascites
medicine
Humans
Splenic Diseases
Tumor marker
biology
business.industry
Gastroenterology
Splenic Rupture
General Medicine
Epidermoid cyst
medicine.disease
digestive system diseases
Abdominal Pain
Carcinoembryonic Antigen
medicine.anatomical_structure
Elective Surgical Procedures
030220 oncology & carcinogenesis
Splenectomy
biology.protein
Female
Laparoscopy
030211 gastroenterology & hepatology
medicine.symptom
Tomography, X-Ray Computed
business
Biomarkers
Subjects
Details
- ISSN :
- 18657265 and 18657257
- Volume :
- 12
- Database :
- OpenAIRE
- Journal :
- Clinical Journal of Gastroenterology
- Accession number :
- edsair.doi.dedup.....6b92ececd2db1af6763bb467e06cd45f