{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T09:37:37Z","timestamp":1771666657490,"version":"3.50.1"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,5,3]],"date-time":"2023-05-03T00:00:00Z","timestamp":1683072000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,5,3]],"date-time":"2023-05-03T00:00:00Z","timestamp":1683072000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["surg case rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>CA19-9 is strongly expressed in malignant tumors of the digestive system and is widely used as a marker for gastrointestinal cancer. In this report, we describe a case of acute cholecystitis in which CA19-9 was markedly elevated.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 53-year-old man was admitted to our hospital with a diagnosis of acute cholecystitis after being referred to our hospital with a chief complaint of fever and right hypochondrial pain. CA19-9 was abnormally high at 17,539.1 U\/ml. Although the possibility of malignancy was considered, there was no obvious malignant lesion on imaging; the patient was diagnosed with cholecystitis, and laparoscopic cholecystectomy was performed the day after admission. The surgical specimen showed no malignant findings either grossly or in the final pathological examination. There were no complications in the patient\u2019s postoperative course, and he was discharged from the hospital on the third postoperative day. CA19-9 level quickly returned to within normal range after surgery.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>In acute cholecystitis, CA19-9 levels exceeding 10,000 U\/ml are very rare. We report a case of acute cholecystitis without malignant findings despite a high CA19-9 level.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40792-023-01648-1","type":"journal-article","created":{"date-parts":[[2023,5,3]],"date-time":"2023-05-03T15:02:38Z","timestamp":1683126158000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["A case of acute cholecystitis with abnormally high CA19-9"],"prefix":"10.1186","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1625-0488","authenticated-orcid":false,"given":"Shinichiro","family":"Oinuma","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deguchi","family":"Yoshio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Syunsuke","family":"Omotaka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takuya","family":"Terunuma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinya","family":"Kasagi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hironobu","family":"Kimura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noboru","family":"Yokoyama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haruhiro","family":"Inoue","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,5,3]]},"reference":[{"key":"1648_CR1","doi-asserted-by":"publisher","first-page":"1941","DOI":"10.1111\/j.1572-0241.1999.01234.x","volume":"94","author":"HJ Kim","year":"1999","unstructured":"Kim HJ, Kim MH, Myung SJ, Lim BC, Park ET, Yoo KS, et al. A new strategy for the application of CA19-9 in the differentiation of pancreaticobiliary cancer: analysis using a receiver operating characteristic curve. Am J Gastroenterol. 1999;94:1941\u20136.","journal-title":"Am J Gastroenterol"},{"key":"1648_CR2","first-page":"41","volume":"78","author":"C Haglund","year":"1989","unstructured":"Haglund C, Kuusela P, Roberts PJ. Tumour markers in pancreatic cancer. Ann Chir Gynaecol. 1989;78:41\u201353.","journal-title":"Ann Chir Gynaecol"},{"key":"1648_CR3","first-page":"2416901","volume":"2017","author":"N Shah","year":"2017","unstructured":"Shah N, Tetangco E, Arshad HMS, Raddawi H. Mirrizi syndrome and markedly elevated levels of carbohydrate antigen 19\u20139 in the absence of malignant disease. Case Rep Gastrointest Med. 2017;2017:2416901.","journal-title":"Case Rep Gastrointest Med"},{"key":"1648_CR4","first-page":"77","volume":"129","author":"R Peterli","year":"1999","unstructured":"Peterli R, Meyer-Wyss B, Herzog U, Tondelli P. CA19-9 has no value as a tumor marker in obstructive jaundice. Schweiz Med Wochenschr. 1999;129:77\u20139.","journal-title":"Schweiz Med Wochenschr"},{"key":"1648_CR5","doi-asserted-by":"publisher","first-page":"474","DOI":"10.1053\/ejso.1999.0925","volume":"26","author":"DV Mann","year":"2000","unstructured":"Mann DV, Edwards R, Ho S, Lau WY, Glazer G. Elevated tumour marker CA19-9: clinical interpretation and influence of obstructive jaundice. Eur J Surg Oncol. 2000;26:474\u20139.","journal-title":"Eur J Surg Oncol"},{"key":"1648_CR6","doi-asserted-by":"publisher","first-page":"862","DOI":"10.1016\/j.pan.2018.09.004","volume":"18","author":"A Tsen","year":"2018","unstructured":"Tsen A, Barbara M, Rosenkranz L. Dilemma of elevated CA 19\u20139 in biliary pathology. Pancreatology. 2018;18:862\u20137.","journal-title":"Pancreatology"},{"key":"1648_CR7","volume":"12","author":"F Giron","year":"2020","unstructured":"Giron F, Alcantar D. Looks can be deceiving: a case report on the clinical value of CA 19\u20139 in obstructive jaundice. Cureus. 2020;12: e6637.","journal-title":"Cureus"},{"issue":"Suppl 2","key":"1648_CR8","first-page":"e43","volume":"139","author":"TO Goetze","year":"2014","unstructured":"Goetze TO, Paolucci V. Immediate radical re-resection of incidental T1b gallbladder cancer and the problem of an adequate extent of resection (results of the German Registry \u201cIncidental Gallbladder Cancer\u201d). Zentralbl Chir. 2014;139(Suppl 2):e43\u20138.","journal-title":"Zentralbl Chir"},{"key":"1648_CR9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/jhbp.526","volume":"25","author":"T Takada","year":"2018","unstructured":"Takada T. Tokyo guidelines 2018: updated Tokyo guidelines for the management of acute cholangitis\/acute cholecystitis. J Hepatobiliary Pancreat Sci. 2018;25:1\u20132.","journal-title":"J Hepatobiliary Pancreat Sci"},{"key":"1648_CR10","doi-asserted-by":"publisher","first-page":"8820","DOI":"10.1038\/s41598-020-65720-8","volume":"10","author":"S Kim","year":"2020","unstructured":"Kim S, Park BK, Seo JH, Choi J, Choi JW, Lee CK, et al. Carbohydrate antigen 19\u20139 elevation without evidence of malignant or pancreatobiliary diseases. Sci Rep. 2020;10:8820.","journal-title":"Sci Rep"},{"key":"1648_CR11","doi-asserted-by":"publisher","first-page":"410","DOI":"10.1159\/000448068","volume":"10","author":"S Akimoto","year":"2016","unstructured":"Akimoto S, Banshodani M, Nishihara M, Nambu J, Kawaguchi Y, Shimamoto F, et al. Acute cholecystitis with significantly elevated levels of serum carbohydrate antigen 19\u20139. 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