[Persistent elevation of Ca 19-9 and an unexpected finding. A case report].

Area of Science:

• Gastroenterology
• Oncology
• Clinical Diagnostics

Background:

• Tumor markers, including Ca 19-9, are produced by tumors or the host in response to cancer.
• Ca 19-9 is commonly used for pancreatic cancer but can be elevated in benign conditions, limiting its specificity.

Observation:

• A patient presented with chronic abdominal pain, weight loss, and persistently high Ca 19-9 levels.
• Work-up revealed hepatic and renal cysts, steatosis, and a gallbladder polyp. Exploratory laparoscopy showed suspected liver metastases, later pathologically confirmed as benign biliary hamartomas, steatosis, and cholecystitis.

Findings:

• Despite the absence of malignancy, Ca 19-9 remained elevated after two years.
• The persistent elevation of Ca 19-9 was attributed to multiple benign conditions: steatosis, urolithiasis, hepatic and renal cysts, and cholecystitis.

Implications:

• Clinical management requires an algorithm for healthy individuals with elevated Ca 19-9 to prevent misdiagnosis and reduce healthcare costs.
• This case highlights the importance of considering benign etiologies for elevated tumor markers.