Supra-elevated CA 19-9 in a benign hepatic cyst adenoma.

BACKGROUND: Elevated CA 19-9 may be found in both cystadenomas and cystadenocarcinomas of the liver. CASE OUTLINE: A 59-year-old woman presented with right upper quadrant abdominal pain, malaise and weight loss. Physical examination and laboratory evaluation revealed a mass in the right upper quadrant and a CA 19-9 level of 68 661 U/ml. CT scan demonstrated a cystic liver mass. She underwent a right hepatectomy, and her CA 19-9 returned to normal. Pathologic analysis revealed no malignancy. DISCUSSION: In hepatic cystic neoplasms, an elevated CA 19-9 should not be used to establish the diagnosis of malignancy nor should it preclude resection.