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Small bowel adenocarcinoma of the jejunum: a case report and literature review.

Li J, Wang Z, Liu N, Hao J, Xu X - World J Surg Oncol (2016)

Bottom Line: This case is reported to arouse a clinical suspicion of SBA in patients with abdominal pain of unknown cause.We also provided evidence in this case of a response to palliative chemotherapy with FOLFOX.Because the incidence of SBA is very low, there is a need for further studies to evaluate the possible application of newer investigative agents and strategies to obtain a better outcome within the framework of international collaborations.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, The Second Affiliated Hospital, Xi'an Jiaotong University Health Science Center, Xi'an, 710004, China.

ABSTRACT

Background: In practice, small bowel cancer is a rare entity. The most common histologic subtype is adenocarcinoma. Adenocarcinoma of the small bowel (SBA) is challenging to diagnose, often presents at a late stage and has a poor prognosis. The treatment of early-stage SBA is surgical resection. No standard protocol has been established for unresectable or metastatic disease.

Case presentation: We report here on a 26-year-old man with SBA in the jejunum, lacking specific symptoms and with a delay of 6 months in diagnosis. The diagnosis was finally achieved with a combination of balloon-assisted enteroscopy, computed tomography scans, positron emission computed tomography scans and the values of carcino-embryonic antigen and carbohydrate antigen 19-9. The patient underwent segmental intestine with lymph node resection, followed by eight cycles of FOLFOX palliative chemotherapy with good tolerance. As of the 11-month postoperative follow-up, there has been no evidence of recurrent disease.

Conclusions: This case is reported to arouse a clinical suspicion of SBA in patients with abdominal pain of unknown cause. We also provided evidence in this case of a response to palliative chemotherapy with FOLFOX. Because the incidence of SBA is very low, there is a need for further studies to evaluate the possible application of newer investigative agents and strategies to obtain a better outcome within the framework of international collaborations.

No MeSH data available.


Related in: MedlinePlus

CT scan image (axial view) showing many swollen lymph nodes adjacent to the abdominal aorta in the retroperitoneal space but no discernible mass
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Fig1: CT scan image (axial view) showing many swollen lymph nodes adjacent to the abdominal aorta in the retroperitoneal space but no discernible mass

Mentions: The patient visited our hospital without any complaints. Physical examination revealed a soft abdomen with tenderness in the left lower quadrant. No mass was palpated in the abdomen. When his abdominal pain occurred, a peristaltic wave could be observed around the navel. Laboratory tests showed no anaemia or leukocytosis. Examination of tumour-associated antigens showed a prominent high levels of carcino-embryonic antigen (CEA) at 29.17 ng/ml and carbohydrate antigen 19-9 (CA 19-9) at 970.3 U/ml. Abdominal computed tomography (CT) scans showed many swollen lymph nodes adjacent to the abdominal aorta in the retroperitoneal space (Fig. 1) but no discernible mass. Positron emission computed tomography (PET)/CT scans revealed abnormal accumulations of 18F-FDP in many stiffening intestinal segments and also in many retroperitoneal swollen lymph nodes, indicating hypermetabolism disease, with a high possibility of a malignant disease (Fig. 2). Gastroscopy and enteroscopy showed that the stomach, colon and rectum were normal. However, double-balloon enteroscopy (DBE) and the following biopsy revealed at the upper jejunum that most of the lumen was obstructed by an irregular protrusive tumour of gastrointestinal origin (Fig. 3a).Fig. 1


Small bowel adenocarcinoma of the jejunum: a case report and literature review.

Li J, Wang Z, Liu N, Hao J, Xu X - World J Surg Oncol (2016)

CT scan image (axial view) showing many swollen lymph nodes adjacent to the abdominal aorta in the retroperitoneal space but no discernible mass
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4940967&req=5

Fig1: CT scan image (axial view) showing many swollen lymph nodes adjacent to the abdominal aorta in the retroperitoneal space but no discernible mass
Mentions: The patient visited our hospital without any complaints. Physical examination revealed a soft abdomen with tenderness in the left lower quadrant. No mass was palpated in the abdomen. When his abdominal pain occurred, a peristaltic wave could be observed around the navel. Laboratory tests showed no anaemia or leukocytosis. Examination of tumour-associated antigens showed a prominent high levels of carcino-embryonic antigen (CEA) at 29.17 ng/ml and carbohydrate antigen 19-9 (CA 19-9) at 970.3 U/ml. Abdominal computed tomography (CT) scans showed many swollen lymph nodes adjacent to the abdominal aorta in the retroperitoneal space (Fig. 1) but no discernible mass. Positron emission computed tomography (PET)/CT scans revealed abnormal accumulations of 18F-FDP in many stiffening intestinal segments and also in many retroperitoneal swollen lymph nodes, indicating hypermetabolism disease, with a high possibility of a malignant disease (Fig. 2). Gastroscopy and enteroscopy showed that the stomach, colon and rectum were normal. However, double-balloon enteroscopy (DBE) and the following biopsy revealed at the upper jejunum that most of the lumen was obstructed by an irregular protrusive tumour of gastrointestinal origin (Fig. 3a).Fig. 1

Bottom Line: This case is reported to arouse a clinical suspicion of SBA in patients with abdominal pain of unknown cause.We also provided evidence in this case of a response to palliative chemotherapy with FOLFOX.Because the incidence of SBA is very low, there is a need for further studies to evaluate the possible application of newer investigative agents and strategies to obtain a better outcome within the framework of international collaborations.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, The Second Affiliated Hospital, Xi'an Jiaotong University Health Science Center, Xi'an, 710004, China.

ABSTRACT

Background: In practice, small bowel cancer is a rare entity. The most common histologic subtype is adenocarcinoma. Adenocarcinoma of the small bowel (SBA) is challenging to diagnose, often presents at a late stage and has a poor prognosis. The treatment of early-stage SBA is surgical resection. No standard protocol has been established for unresectable or metastatic disease.

Case presentation: We report here on a 26-year-old man with SBA in the jejunum, lacking specific symptoms and with a delay of 6 months in diagnosis. The diagnosis was finally achieved with a combination of balloon-assisted enteroscopy, computed tomography scans, positron emission computed tomography scans and the values of carcino-embryonic antigen and carbohydrate antigen 19-9. The patient underwent segmental intestine with lymph node resection, followed by eight cycles of FOLFOX palliative chemotherapy with good tolerance. As of the 11-month postoperative follow-up, there has been no evidence of recurrent disease.

Conclusions: This case is reported to arouse a clinical suspicion of SBA in patients with abdominal pain of unknown cause. We also provided evidence in this case of a response to palliative chemotherapy with FOLFOX. Because the incidence of SBA is very low, there is a need for further studies to evaluate the possible application of newer investigative agents and strategies to obtain a better outcome within the framework of international collaborations.

No MeSH data available.


Related in: MedlinePlus