CEA and CA19-9 levels in the cystic fluid were elevated not only in patients with biliary cystadenoma and cystadenocarcinoma[18,19] but also in patients with simple hepatic cysts[20,21]; therefore, tumor marker levels in serum and cystic fluid are not useful for distinguishing between a hemorrhagic hepatic cyst and cyst-forming IPNB. The gene discussed is CEACAM5; the disease is neoplasm.