[A case of hydronephrosis with high level of serum Span-1 antigen and CA19-9]

A sixty-year-old woman visited our hospital with a complaint of left flank pain. Laboratory data showed a high level of serum CA19-9. Computerized tomography and ultrasonography revealed left hydronephrosis and hydroureter. No tumors were found in the liver, pancreas, gallbladder, gastrointestinal tract or genitourinary tract. The serum SPan-1 antigen level was elevated to 250 U/ml, and the serum CA19-9 level was also elevated to 580 U/ml. Since urological malignancy was not excluded from these findings, left nephroureterectomy was performed. Pathological findings revealed chronic inflammation, and malignant cells were not found in the resected specimens. Although high levels of SPan-1 antigen and CA19-9 have been reported in benign diseases, both are usually less than 100 U/ml. In this case, serum SPan-1 antigen and CA19-9 levels were extremely high (more than 1,000 U/ml). Since the serum SPan-1 antigen and CA19-9 levels were gradually reduced to normal levels within 4 months after the operation, a possible explanation for the high levels of the two tumor markers is hydronephrosis in the left kidney. We report this interesting hydronephrosis associated with high levels of serum SPan-1 antigen and CA19-9.