AN OPERATED CASE OF SYNCHRONOUS DOUBLE CANCER (MALIGNANT LOCALIZED PLEURAL MESOTHELIOMA AND GASTRIC CANCER) WITH PRODUCING OF CA19-9

Abstract

A 65-year-old man was admitted to the hospital because of general fatigue and anorexia. He was diagnosed as having a gastric cancer and sarcoma of the lung or pleural mesothelioma by gastric endoscopy and lung biopsy. Serum level of CA19-9 was 80U/ml (<37) and CEA was 32ng/ml (<2.5). After total gastrectomy, serum CEA decreased to 8.7ng/ml and CA19-9 elevated to 563U/ml. The lung tumor was rapidly growing and a chest pain increased. Forty days after the first operation, partial resection of the right upper lobe with thoracic wall resection was performed. Histologically, malignant localized mesothelioma was diagnosed. Serum level of CA19-9 decreased to 65U/ml. Postoperative course was uneventful, but he died of cachexia five months after the administration. The incidence of malignant mesothelioma is rare and the prognosis of the disease is very poor, so this is the first operated case of synchronous double cancer (malignant mesothelioma and gastric cancer). Immunohistological staining showed CA19-9 in both mesothelioma and gastric cancer. We suppose that CA19-9 was produced during the differential process of the mesothelioma.