[Prostate cancer with high serum level of CEA and CA19-9: a case report]

We report a case of primary adenocarcinoma of the prostate cancer producing carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9). An 80-year-old man admitted to our hospital with the complaint of appetite loss. Serum CEA and CA19-9 levels were increased to 28.9 ng/ml (normal < 3.5) and 271 U/ml (normal < 37), respectively. Serum PSA level was also high (33 ng/ml; normal < 3.6). Computed tomography (CT) demonstrated para-aortic lymph node swelling and bone scan revealed multiple bone metastasis. Prostate biopsy was performed and the specimen showed no evidence of malignancy. However endocrine therapy was started because of the strong suspicion of prostate cancer. In spite of the treatment, the patient died 2 months after the treatment. Histology of autopsy specimen demonstrated primary prostate cancer (poorly differentiated adenocarcinoma) and metastases to multiple organs, such as lungs, liver, thyroid, bone marrow and adrenals. Immunohistochemical staining for CEA, CA19-9 and PSA demonstrated the existence of each protein at both primary and metastatic sites.