Elevated CEA and Medullary Cell Carcinoma

25 years old female was investigated for a nonspecific abdominal pain history and was found to have elevated CEA (carcinogenic embryonic antigen). The work up for gastrointestinal malignancy included upper and lower gastrointestinal endoscopy and a contrast enhanced CT abdomen. The endoscopy findings were inconclusive while the CT abdomen revealed a 1cm nodule in left adrenal gland, which was of doubtful clinical significance, and not likely cause of elevated CEA.