Unusually High CA 19-9 in Gastric Cancer: A Case of Papillary Adenocarcinoma with Metastases
Keywords:
Gastric cancer, Papillary adenocarcinoma, CA 19-9Abstract
Carbohydrate antigen 19-9 (CA 19-9) is a recognized tumour marker for pancreatic and biliary tract malignancies. Markedly elevated CA 19-9 in gastric carcinoma may lead to diagnostic ambiguity. This case illustrates an unusually raised CA 19-9 in the context of gastric cancer. Here, our patient, a 70-year-old woman, came for evaluation of anorexia, fatigue, significant weight loss, abdominal pain, and constipation for three months. She had anaemia and hepatomegaly. Her haemoglobin level and serum albumin were reduced (8.6 g/dl and 28 g/L respectively). Tumour markers assay revealed significant elevation (10800 U/ml) of CA 19-9 level (normal: <37 U/ml). Contrast-enhanced computed tomography (CECT) of the whole abdomen showed infiltrative growth at the lower part of the body and pyloric part of the stomach with proximal distension, abdominal lymphadenopathy, multiple hepatic metastases, and normal pancreatic or biliary tract. Upper gastrointestinal (UGI) endoscopy revealed an ulcero-proliferative lesion in the antrum involving the lower body and pylorus leading to partial gastric outlet obstruction. Subsequently, gastric tissue biopsy confirmed papillary adenocarcinoma, grade II. At this stage, the patient’s family refused further oncological management. One and a half months later, we came to know that the patient eventually passed away. From this case scenario, it can be concluded that though markedly raised CA 19-9 alone is not diagnostic for gastric cancer, yet can be correlated with tumour burden and disease progression in the context of confirmed gastric malignancy with metastases.
J MEDICINE 2026; 27(2): 155-157
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