The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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A Case Report of Papillary Thyroid Carcinoma Presenting as Elevated Serum CA 19-9

건강 검진 시 혈청 CA 19-9 증가로 발견된 갑상선유두암 1예

  • Jang, Eun Kyung (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Choi, Yun Mi (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Ho Cheol (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Tae Yong (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Hong, Suck Joon (Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Shong, Young Kee (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Won Bae (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • 장은경 (울산대학교 의과대학 서울아산병원 내과) ;
  • 최윤미 (울산대학교 의과대학 서울아산병원 내과) ;
  • 김호철 (울산대학교 의과대학 서울아산병원 내과) ;
  • 김태용 (울산대학교 의과대학 서울아산병원 내과) ;
  • 홍석준 (울산대학교 의과대학 서울아산병원 외과) ;
  • 송영기 (울산대학교 의과대학 서울아산병원 내과) ;
  • 김원배 (울산대학교 의과대학 서울아산병원 내과)
  • Published : 2013.01.01
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Abstract

A 47-year-old man had elevated serum CA 19-9 after a routine health check-up. He had normal CA 19-9 levels during the preceding 8 years on annual heath checks. Imaging studies for pancreatic or biliary tract diseases revealed no abnormalities. A huge hypermetablic lesion was found in the right lobe of the thyroid on $^{18}F$-fluorodeoxyglucose positron emission tomography/computed tomography. We performed a fine needle aspiration of the thyroid nodule. He was diagnosed with papillary thyroid carcinoma and underwent a total thyroidectomy with a modified radical neck dissection. Serum CA 19-9 level decreased to the normal range after surgery. Although there have been few reports of patients with elevated serum CA 19-9 levels due to papillary thyroid carcinoma, this is the first report showing such an association in Korea. Thyroid cancer should be considered when the causes of elevated serum CA 19-9 are unclear.

본 증례는 수술 전 증가되었던 혈청 CA 19-9 농도가 갑상선전절제술 후 정상화되었고, 갑상선내 다른 병리 소견이 없어서 갑상선유두암 조직이 CA 19-9 분비의 원인이었음을 알수 있는 증례이다. 이는 혈청 CA 19-9 증가의 원인으로서 밝혀진 갑상선유두암의 국내 첫 증례 보고이며, 췌장 담도 질환이 동반되지 않은 환자에서 혈청 CA 19-9 증가가 있다면 갑상선암의 가능성도 고려해야 함을 시사한다.

Keywords

References

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