CEA，CA19-9の異常高値を呈した腰椎硬膜内・硬膜外膿瘍の1例

A Case of Lumbar Intradural and Epidural Abscesses Presenting with Elevated Serum Carcinoembryonic Antigen（CEA）and Carbohydrate Antigen 19-9（CA19-9）

要旨　血清および髄液中のCEA，CA19-9が極めて高い異常値を呈し，腰椎硬膜内・硬膜外膿瘍がその原因と考えられた1症例を経験した。神経系の非腫瘍性疾患においてこれらの腫瘍マーカーが上昇した例の報告は極めて少なく，本症例も悪性腫瘍が併存しているか否かが常に問題となり診断には大変苦慮した。神経系感染症とこれらの腫瘍マーカーとの関連についても考察を加え報告する。

An 81-year-old woman was admitted to our service because of high fever and severe lumbar pain. Neurological examination showed a nuchal stiffness and sensory disturbance of the lower extremities. CSF findings showed significantly elevated neutrophils and decreased glucose. MRI demonstrated intradural and epidural abscesses within the lumbar canal. In early stages of the disease, we unexpectedly found the elevated serum CEA and CA19-9. Although those tumor markers showed very high titers, we never found any evidence of the malignant tumor. Interestingly, those markers obviously decreased with the improvement of the abscess within the lumbar canal. We discussed the importance of CEA and CA19-9 in the infectious neurological diseases.