Normalization of CEA, CA15-3, and CA27-29 Tumor Markers Following Single Lung Transplant in a Patient With a History of Early-Stage Breast Cancer and Idiopathic Pulmonary Fibrosis: A Case Report.

backgroundThe use of serum tumor markers can provide additional information about a patient's response to treatment, but their use has been controversial in the management of breast cancer (BC) because of a lack of standardization. CEA, CA15-3, and CA27-29 are used to monitor disease activity in metastatic BC (MBC), but they have poor sensitivity and specificity in early-stage BC. Some oncologists or lung transplant centers may test these tumor markers to detect potential occult existing malignancy in patients who are eligible for transplant. However, these tests may provide inaccurate results and cause unnecessary delays in performing the transplant. CASE REPORT: Herein we present a case of a 52-year-old woman who had early-stage BC, underwent cancer treatment, and later developed idiopathic pulmonary fibrosis (IPF) that required a lung transplant. Her previous oncologist tested her tumor markers, which were elevated. Multiple scans over the years did not show any evidence of recurrence. After her single lung transplant, her serum tumor markers normalized. DISCUSSION/

conclusionElevated tumor markers might be a result of the severity of IPF rather than an indication of recurrence. To our knowledge, this is the only case report demonstrating complete normalization of the three serum tumor markers-CEA, CA15-3, and CA27-29-following a single lung transplant. Increasing awareness of this phenomenon in patients with IPF, who are candidates for lung transplantation, could help prevent unnecessary scans and tumor marker tests, thereby avoiding potential delays in accessing this lifesaving procedure.