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Gastroenterology Research and Practice
Volume 2011, Article ID 123743, 4 pages
Case Report

Two Patients with Extremely Elevated Tumor Markers: Where Is the Malignancy?

1Departments of Internal Medicine, Gastroenterology, and Hepatology, Medisch Centrum Haaglanden, P.O. Box 432, 2501 CK The Hague, The Netherlands
2Department of Gastroenterology and Hepatology, Isala Clinics, P.O. Box 10500, 8000 GM Zwolle, The Netherlands
3Department of Gastroenterology and Hepatology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands

Received 3 March 2011; Accepted 26 April 2011

Academic Editor: Stuart Sherman

Copyright © 2011 Patrick P. J. van der Veek et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Serum tumor markers are useful to evaluate a cancer's response to treatment, for early detection of cancer relapse, and, in some cases, to diagnose malignancy. In this paper, we present two patients with significantly elevated serum tumor markers without evidence of malignant disease. An 18-year-old patient suffering from autoimmune hepatitis had markedly increased alpha-fetoprotein (aFP) levels (2,002 μg/L; normal <10 ug/L). Extensive imaging showed no signs of hepatocellular carcinoma or other cancer, and treatment with Prednisone led to rapid normalization of both liver enzymes and aFP. The second patient, a 60-year-old female with painless jaundice due to biliary stone disease, had very high serum levels of CA19-9 (18,000 kU/L, normal <27 kU/L). Liver biochemistry and serum CA19-9 concentration decreased to almost normal values (45 kU/L) after biliary stenting. These cases demonstrate that serum tumor markers can be elevated in benign disease and are therefore not appropriate to diagnose cancer.