2014 Volume 47 Issue 11 Pages 690-696
A 62-year-old woman showed an abnormal shadow in upper left lung field in chest X-ray. Her sialyl LewisX (SLX) was 150 U/ml and lung cancer was suspected. Bronchoscopic biopsy was performed and the diagnosis of moderate to well-differentiated adenocarcinoma was obtained. Abdominal CT examination also showed a cystic lesion with a nodule approximately 7 cm in diameter in the lateral segment of the liver. We proceeded treatment of the lung cancer first, and the left upper lobectomy was performed. Curative resection was performed. However, after surgery, SLX elevated to more than 2,000 U/ml. FDG-PET CT examination was ordered, though only physiological accumulation was seen. With the diagnosis of cystic liver tumor, left lateral segmentectomy was performed 3 months after pulmonary resection. The resected specimen showed multilocular cystic lesions with nodules in part, and cystic fluid was mucinous. The SLX of cyst fluid was more than 2,000 U/ml. Histopathologically, the resected cystic lesions were diagnosed as intraductal papillary neoplasm of the bile duct (IPNB). SLX showed decreased 40 U/ml in about one month after the surgery. We report this rare case of IPNB which showed high serum SLX level.
