A CASE OF XANTHOGRANULOMATOUS CHOLECYSTITIS WITH SIGNIFICANTLY ELEVATED LEVELS OF SERUM CARBOHYDRATE ANTIGEN 19-9 - A RARE CASE REPORT

Serum carbohydrate antigen 19-9 (CA 19-9), a marker of malignant tumors, is generally slightly elevated in benign conditions. We report a case of xanthogranulomatous cholecystitis with a signicantly elevated level of serum CA 19-9 levels. A 27-year-old woman presented with abdominal pain, intermittent vomiting, jaundice and loss of appetite. Ultrasonography, contrastenhanced computed tomography and magnetic resonance cholangiopancreatography were carried out whichrevealed an irregular gallbladder wall thickening with loss of gall bladder hepatic interface. The serum CA 19-9 level was signicantly elevated to 7590 U/ml. The patient then underwent exploratory laparotomy and cholecystectomy 12 days after admission. Intraoperative frozen section was performed to rule out malignancy and diagnosis of xanthogranulomatous cholecystitis was made. Subsequently histopathological examination was done and the diagnosis of xanthogranulomatous cholecystitis was conrmed. The levels of Carbohydrate antigen 19-9 returned to normal post surgery. Xanthogranulomatous cholecystitis with a signicantly high elevation of the serum CA 19-9 level is rare. In such cases, it is important to conrm and distinguish between inammation and malignancy.