Abstract
The patient was a 63-year-old female admitted to our hospital for cholecystolithiasis. Since serum CA 19-9 level was as high as 713 U/ml, malignancy was suspected, and further examination, abdominal ultrasonography and CT were performed. As a result, the patient was diagnosed as cholecystolithiasis with chronic cholecystitis and underwent laparoscopic cholecystectomy. Twelve mixed stones were found in the resected gallbladder. Histology demonstrated the findings of chronic cholecystitis. The CA 19-9 level in the bile juice was 1.98 x 106 U/ml, and immunohistological staining of the gallbladder mucosa demonstrated strong positivity in epithelial cells. Serum CA 19-9 level was normalized to 15.8 U/ml, postoperatively. CA 19-9 has been widely used as an useful marker for diagnosing malignant tumors in the pancreatobiliary system. However, the serum CA 19-9 level is sometimes increased in benign diseases such as cholecystolithiasis. Therefore differential diagnosis of benign and malignancy requires comprehensive evaluation of the disease based on the results of several examination including those of various diagnostic imaging.
