Highly elevated serum levels of CA 19-9 in choledocholithiasis: a case report

We present a case of a 79-year-old woman admitted to our hospital with pain in the right upper abdominal quadrate radiated to the back, jaundice, fever and chills. The laboratory tests showed serum carbohydrate antigen 19-9 levels of 99.070 U/ml (normal values: 0-37 U/ml). The rest of the biochemistry showed alkaline phosphatase of 550 IU/l, direct bilirubin: 17.5 mg/dl, total bilirubin: 28.4 mg/dl. Abdominal sonography demonstrated dilated common bile duct. Two weeks postoperatively, the carbohydrate antigen 19-9 fell to 970 U/ml and returned within normal range (31 U/ml) two months later. Furthermore, the magnetic resonance cholangiopancreatography performed postoperatively demonstrated normal configuration of the biliary tree and the common bile duct.