1989 Volume 50 Issue 12 Pages 2640-2644
A 25-year-old woman was admitted to our hospital with the chief complaint of hepatomegary. Her liver was palpable three finger breadths below the right costal margin. Laboratory studies showed a normal liver function. Plasma CA19-9 was elevated up to 10000U/ml, while CEA and AFP were within normal limits. Ultrasonography and cornputed tomography revealed a cystic lesion of 17cm in diamater with septum and a few papillary processes in the right hepatic lobe. Angiography demonstrated a hypovascular tumor with focal tumor stains. Ultrasonicallly guided percutaneous fine needle aspiration cytology of the cyst showed no malignant cells. The levels of CEA and CA19-9 of the cyst were 4470ng/ml and over 10000U/ml, respectively. Right hepatic trisegmentectomy was then performed under the diagnosis of bilialy cystadenocarcinoma, which was confirmed by pathologic examination pOstoperatively. CEA and CA19-9 were demonstrated in the tumor cells immunohistochemically. Tissue contents of CEA and CA19-9 were higher in the tumor compared to the normal liver tissue. We reviewed 60 cases of biliary cystadenocarcinoma reported in the Japanese literature and discussed the clinical significance of the aspiration assay for this disease.
