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Bronchogenic cyst with high serum carcinoembryonic antigen
Takahiro Oto1, Akio Ando, Motoi Aoe
1Department of Surgical Oncology and Thoracic Surgery (Surgery II), Okayama University Graduate Schools, 2-5-1 Shikata-cho, Okayama 700-8558, Japan.
The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka Gakkai Zasshi
|March 21, 2003
Summary
A large subcarinal cyst was successfully removed from a 64-year-old woman. This resolved her elevated serum carcinoembryonic antigen (CEA) levels, confirming the cyst as the source.
Area of Science:
- Thoracic surgery
- Surgical oncology
- Gastroenterology
Background:
- Elevated serum carcinoembryonic antigen (CEA) can indicate malignancy, but benign conditions can also cause increased levels.
- Bronchogenic cysts are congenital lung malformations that can rarely cause paraneoplastic syndromes or mass effects.
- Subcarinal cysts are located in the mediastinum, posing diagnostic and therapeutic challenges.
Observation:
- A 64-year-old female patient presented with a large subcarinal cyst.
- Pre-operative serum CEA levels were significantly elevated at 55.7 ng/ml.
- The cyst was successfully resected using video-assisted thoracoscopic surgery (VATS).
Findings:
- Pathological examination confirmed the cyst to be benign, specifically a bronchogenic cyst.
- Immunohistochemistry revealed the presence of CEA within the cyst's stratified columnar epithelial lining.
- Post-operative serum CEA levels normalized within 40 days following surgical removal.
Implications:
- This case highlights that benign bronchogenic cysts can be a source of significantly elevated serum CEA.
- Thoracoscopic resection is an effective treatment for symptomatic or CEA-elevating subcarinal cysts.
- Measuring serum CEA may aid in the diagnosis and monitoring of select benign thoracic cysts.