A 40-year-old woman with back pain, an abdominal mass, and a serum CEA level of 200 ng/ml was found to have at laparotomy, a large but resectable mucinous retroperitoneal mass. Pathologic diagnosis revealed cystadenocarcinoma, probably of pancreatic origin. It is remarkable that the cyst fluid contained a CEA level 100,000-fold normal. Serum CEA fell to normal levels in the postoperative period. This suggests that the CEA was of cyst epithelial origin.
Cancer 42~632-634, 1978.
LEVATED LEVELS OF carcinoembryonic E antigen (CEA) have been described in serum and biological fluids of patients with gastrointestinal carcinoma. The main biological fluid that has been assayed in patients with gastrointestinal carcinoma is pancreatic juice.5
The maximum concentration of CEA in pancreatic secretions in patients with pancreatic carcinoma approaches 1000 times that of the serum level in normal individuals. In pancreatic cancer very high serum values of CEA are indicative of hepatic metastases6 A cystadenocarcinoma was encountered and was associated with an extremely high level of CEA with a concentration in the contents of the tumor approaching 100,000 times that of normal serum. Complete surgical removal of the primary tumor resulted in the fall of the circulating CEA levels to normal. These findings suggest that the columnar epithelium of a cystadenocarcinoma may synthesize and secrete a mucous which is extremely high in CEA.