- 期刊
Elevated CEA in a Breast Cancer Patient with Overlooked Mixed Medullary-Papillary Thyroid Carcinoma
乳癌病患術後因癌胚抗原升高而診斷出混合性髓質性及乳突狀甲狀腺癌
摘要
癌胚抗原（Carcinoembryonic antigen，簡稱CEA）是一常見的胃腸道和乳腺惡性腫瘤的腫瘤標記。對於有持續性CEA升高的患者，醫師通常會進行一系列的檢查，以期找到臨床表徵並不明顯的潛在性惡性腫瘤。然而，高CEA血中濃度也可見於一些良性的狀況。我們在此報告一個乳癌患者，在接受手術及化療後有持續性的血清CEA升高現象。在經過一系列檢查之後，發現病人有一混合性髓質性及乳突狀甲狀腺癌，並成功進行手術治療。對於有高血清CEA的患者，神經內分泌腫瘤，如甲狀腺髓質癌，應列入鑑別診斷。FDG-PET掃描可能是一個檢測隱匿性甲狀腺髓質癌的理想工具。
並列摘要
Carcinoembryonic antigen (CEA) is a tumor marker commonly associated with gastrointestinal and breast malignancy. For patients with persistent elevated CEA, a series of examinations should be performed in order to find a possible underlying occult malignancy that may not be clinically apparent. However, high CEA levels can also be found in benign conditions. We present a patient with persistently elevated CEA after breast cancer surgery and chemotherapy. Following an extensive survey, an overlooked mixed medullary-papillary thyroid carcinoma was identified as the cause of the elevated CEA, which was successfully treated with surgery. For patients with an elevated CEA, a tumor of neuroendocrine origin should be considered, such as medullary thyroid cancer (MTC). In order to facilitate accurate diagnosis, an FDG-PET scan may be an ideal tool to detect occult MTC.