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Extralobar pulmonary sequestration showing high CA 19-19 levels.

D Fontana1, V Della Beffa, M Fusca

  • 1Surgery B Unit, San Giovanni Bosco Hospital, Corso Chieri 184, 10132 Turin, Italy. diegfo@libero.it

Minerva Chirurgica
|February 9, 2007
PubMed
Summary

A cystic mass in the chest was diagnosed as extralobar sequestration in a woman with elevated cancer antigen 19-9 (CA 19-9). This highlights the importance of considering pulmonary sequestration with elevated tumor markers, especially when CT scans are inconclusive.

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Area of Science:

  • Thoracic Surgery
  • Diagnostic Imaging
  • Pathology

Background:

  • Pulmonary sequestration, a congenital lung malformation, can present with vague symptoms.
  • Elevated tumor markers, such as cancer antigen 19-9 (CA 19-9), are typically associated with gastrointestinal malignancies.
  • The association between pulmonary sequestration and elevated tumor markers is less commonly reported in Western literature.

Observation:

  • A 40-year-old woman presented with left thoracic pain and a cystic mass in the left pleural cavity.
  • Preoperative serum CA 19-9 levels were significantly elevated at 2,900 IU/mL.
  • Gastrointestinal investigations did not reveal any neoplastic lesions.

Findings:

  • Intraoperative findings revealed an anomalous systemic arterial supply to the cystic mass.

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  • Histopathological examination confirmed the diagnosis of extralobar sequestration.
  • The elevated CA 19-9 levels were attributed to the common embryogenic origin of respiratory and digestive systems.

    • Implications:

    • This case underscores the importance of considering extralobar sequestration in the differential diagnosis of cystic thoracic masses with elevated tumor markers.
    • Preoperative diagnosis can be challenging, particularly when CT scans do not clearly show anomalous systemic vascular supply.
    • Recognizing this association, often reported in Japanese literature, can aid in timely diagnosis and management.