Esophageal cyst producing CA19-9 and CA125.

Area of Science:

• Gastroenterology
• Surgical Oncology
• Pathology

Background:

• A 59-year-old woman presented with an incidentally discovered posterior mediastinal cyst and ovarian cystoma.
• Elevated serum levels of carbohydrate antigen 19-9 (CA19-9) and carbohydrate antigen 125 (CA125) were noted.
• Initial diagnosis of ovarian dermoid cyst was confirmed post-surgery, but elevated tumor markers persisted.

Observation:

• The patient developed dysphagia, and the posterior mediastinal cyst enlarged.
• The cyst fluid demonstrated extremely high concentrations of CA19-9 and CA125.
• Histological examination revealed an esophageal cyst with specific epithelial lining.

Findings:

• Immunohistochemical staining confirmed CA19-9 and CA125 expression in the cyst-lining epithelial cells.
• The resected esophageal cyst was identified as the source of the elevated tumor markers.
• Post-operative normalization of serum CA19-9 and CA125 levels was observed.

Implications:

• This case highlights a rare instance of an esophageal cyst producing significant levels of CA19-9 and CA125.
• Esophageal cysts should be considered in the differential diagnosis of unexplained elevated CA19-9 and CA125, especially with mediastinal involvement.
• Successful surgical resection led to the resolution of elevated tumor markers, underscoring the importance of accurate diagnosis and treatment.