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Related Concept Videos

Cholecystitis01:20

Cholecystitis

Cholecystitis is inflammation of the gallbladder, most commonly caused by obstruction of the cystic duct. This blockage prevents bile from draining, leading to gallbladder distension, inflammation, and potentially serious complications. This condition may present acutely or chronically and can happen with or without gallstones.EtiologyAbout 95% of cholecystitis cases are calculous, caused by gallstones blocking the cystic duct, leading to bile accumulation and inflammation of the gallbladder...
Acute Pancreatitis II: Clinical Manifestations and Management01:30

Acute Pancreatitis II: Clinical Manifestations and Management

Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
Acute Pancreatitis I: Introduction01:25

Acute Pancreatitis I: Introduction

Acute pancreatitis is the sudden inflammation of the pancreas caused by the early activation of digestive enzymes, leading to the autodigestion of pancreatic tissue. This results in local inflammation and, in severe cases, systemic complications.EtiologyUnderstanding the underlying causes is crucial, as identifying the etiology guides treatment and anticipates complications. Acute pancreatitis can be triggered by various factors, typically grouped into the following clinical categories.Biliary...
Diseases of the Liver and Gallbladder01:26

Diseases of the Liver and Gallbladder

Liver and gallbladder diseases are a significant health concern, with prominent conditions including cirrhosis, hepatitis, non-alcoholic fatty liver disease (NAFLD), and gallstones. Jaundice is a common manifestation of liver and biliary disease.
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not related to...
Chronic Pancreatitis I: Introduction01:24

Chronic Pancreatitis I: Introduction

The pancreas, an elongated and flat gland situated behind the stomach, serves a vital function in digesting food and managing blood sugar levels.
Pancreatitis is the inflammation of the pancreas, which occurs when the immune system becomes active and causes swelling, pain, and disruptions in organ function. Pancreatitis can manifest as either an acute or chronic condition.
Acute pancreatitis arises suddenly and lasts for a brief duration, while chronic pancreatitis is a long-term affliction...
Cirrhosis I: Introduction01:23

Cirrhosis I: Introduction

Cirrhosis is a chronic, irreversible liver disease characterized by the widespread replacement of healthy liver tissue with fibrotic scar tissue and the formation of regenerative nodules.Etiology of cirrhosisCirrhosis results from sustained liver injury that triggers progressive fibrosis and structural remodeling. The underlying causes are diverse, encompassing common and less frequent clinical conditions. Regardless of the origin, all causes lead to chronic inflammation, hepatocyte loss, and...

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Updated: May 16, 2026

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
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Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction

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Biliary obstruction induces extremely elevated serum CA 19-9 levels: case report.

Cem Onal1, Tamer Colakoglu, Serife N Ulusan

  • 1Department of Radiation Oncology, Baskent University Faculty of Medicine, Adana, Turkey. hcemonal@hotmail.com

Onkologie
|December 5, 2012
PubMed
Summary

Extremely high carbohydrate antigen (CA) 19-9 levels can be misleading, as this case shows a patient with malignancy-level CA 19-9 but no tumor. This highlights the need for comprehensive diagnostic approaches beyond a single biomarker.

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Area of Science:

  • Oncology
  • Gastroenterology
  • Diagnostic Biomarkers

Background:

  • Carbohydrate antigen (CA) 19-9 is a tumor marker commonly used for pancreaticobiliary cancers.
  • Elevated CA 19-9 levels can also occur in non-malignant conditions like cholestasis and biliary obstruction.
  • High CA 19-9 is suggestive of malignancy but not definitive.

Observation:

  • A 50-year-old male presented with jaundice and markedly elevated CA 19-9 (161,902 IU/ml).
  • Repeated biopsies and imaging suggested a mass, but no malignancy was found.
  • A Whipple procedure confirmed the absence of a tumor.

Findings:

  • Post-surgical CA 19-9 levels normalized (27 IU/ml), correlating with the resolution of the obstructive jaundice.
  • The case demonstrates a significant discrepancy between CA 19-9 levels and the presence of malignancy.
  • Radiological findings, including PET scans, were suggestive of metastasis but ultimately misleading.

Implications:

  • CA 19-9 levels alone should not be the sole basis for diagnosing malignancy.
  • Diagnostic imaging, while valuable, can yield false positives requiring further investigation.
  • Surgical exploration may be necessary to definitively rule out malignancy and prevent misdiagnosis.