A case of CEA-producing renal pelvic and ureteral cancer

We report a case of carcinoembryonic antigen (CEA)-producing renal pelvic and ureteral cancer. A 62-year-old man consulted a local hospital with the chief complaint of right flank pain. On ultrasonography and CT scan, right hydronephrosis with the renal pelvis and ureteral tumor were detected, and he was referred to our hospital. Both serum levels of CEA and CA19-9 were elevated to 36.9 ng/ml and 119 u/ml, respectively. Close examination of the gastro-intestinal tract did not detect any sign of digestive tumor. Right nephro-ureterectomy was performed, and the tumor was histologically diagnosed as TCC G2 > G3 pT3, and CEA was positive in the tumor cells immunohistochemically. CA19-9 was also positive both in the tumor cells and normal epithelium of the renal tubules. Postoperatively, multiple lung metastases developed despite chemotherapy and the patient died 4 months after surgery. CA19-9 had immediately decreased to the normal range after preoperative percutaneous nephrostomy. CEA had transiently decreased postoperatively, but then increased with lung metastases, apparently related to the state of cancer.