1/136. A case of aberrant pancreatic cancer in the jejunum.We report a case of aberrant pancreatic cancer of the jejunum in a 63 year-old man. The patient was admitted to our hospital with epigastric discomfort and vomiting due to obstruction of the jejunum. laparotomy revealed a submucosal tumor on the jejunum with multiple liver metastases. Histological examination showed the tumor to be a well differentiated tubular adenocarcinoma originating from aberrant pancreatic tissues lacking islets. Only 1 case of aberrant pancreatic cancer in the jejunum has been previously reported in the literature.- - - - - - - - - - ranking = 1keywords = adenocarcinoma, carcinoma (Clic here for more details about this article) |
2/136. Enteroscopic identification of an adenocarcinoma of the small bowel in a patient with previously unrecognized hereditary nonpolyposis colorectal cancer syndrome.Tumors of the small bowel are uncommon and seldom suspected on a clinical basis. Together with the relative inaccessibility of the small bowel to endoscopic investigation, the rarity of these tumors undoubtedly delays their diagnosis. The case reported is of a patient with an adenocarcinoma of the jejunum presenting as gastrointestinal bleeding of obscure origin. diagnosis was by push enteroscopy, after several years of unsuccessful radiological and upper and lower endoscopic evaluation. The patient's family fulfilled the Amsterdam criteria for hereditary nonpolyposis colorectal cancer syndrome, which was previously unrecognized. This report emphasizes the value of push enteroscopy and the limits of radiography of the small bowel when investigating patients with obscure GI bleeding. It also underlines the importance of a careful evaluation of the pedigree (concerning history of colorectal and extracolonic cancer) of all patients, including those who present with adenocarcinoma of the small bowel; it is similarly important to consider the possibility of small bowel cancer in members of families with hereditary nonpolyposis colorectal cancer (HNPCC) syndrome.- - - - - - - - - - ranking = 6keywords = adenocarcinoma, carcinoma (Clic here for more details about this article) |
3/136. Carcinoma in jejunal pancreatic heterotopia.BACKGROUND: Although heterotopic pancreas in the gastrointestinal tract is not uncommon, jejunal pancreatic heterotopia is a rare finding, and malignant transformation in such a location is very unusual. methods: We encountered a case of jejunal carcinoma in pancreatic heterotopia and because of its rarity, we reviewed the Armed Forces Institute of pathology experience as well as the literature. The clinical, histopathologic, and immunohistochemical features were studied. RESULTS: In 109 patients diagnosed as having pancreatic heterotopia in the gastrointestinal tract between 1970 and 1997 at the Armed Forces Institute of pathology, 67 cases (62%) occurred in the stomach, 42 (38%) in the small intestine, and none in the large intestine. We found 2 patients with adenocarcinoma arising in pancreatic heterotopia. The 2 cases arose in the jejunum. One was of the ductal type, while the other was an acinar cell carcinoma with focal ductular differentiation. In both cases the nontumoral pancreatic tissue contained ducts, acini, and islets. review of the literature yielded 26 reports of 28 cases of carcinoma arising in heterotopic pancreas; of these, 18 were well documented. Only 1 occurred in the jejunum, and none was of the acinar type. CONCLUSIONS: Carcinoma in pancreatic heterotopia is rare, and acinar cell carcinoma in pancreatic heterotopia is extremely rare. Recognition of carcinoma in pancreatic heterotopia is important to prevent its misinterpretation as a metastatic tumor.- - - - - - - - - - ranking = 2.0581677783294keywords = adenocarcinoma, carcinoma (Clic here for more details about this article) |
4/136. Tumor seeding of the jejunostomy site after transhiatal esophagectomy for esophageal carcinoma.A 65-year-old male patient with squamous cell carcinoma of the esophagus had a transhiatal esophagectomy after a prophylactic tube jejunostomy. The tube was removed 3 weeks after surgery. Ten months later, a painless 2-cm abdominal mass was noted at the previous jejunostomy site. Subsequent segmental resection of the jejunum disclosed metastatic squamous cell carcinoma of the esophagus. It is possible that tumor seeding may develop at the jejunostomy site after transhiatal esophagectomy for esophageal carcinoma.- - - - - - - - - - ranking = 1.4814348896612keywords = carcinoma (Clic here for more details about this article) |
5/136. Case report: adenocarcinoma arising in a Crohn's stricture of the jejunum.patients with Crohn's disease affecting the small intestine appear to have an increased risk of developing adenocarcinoma. However, it remains an uncommon complication of an uncommon disease. The diagnosis is difficult to make both pre- and intra-operatively, and is most commonly made postoperatively on histopathology. Hence, at laparotomy, consideration should be given to performing a frozen section on all small bowel strictures due to Crohn's disease to define the presence of dysplasia or cancer. This will assist the surgeon in deciding whether to perform a stricturoplasty or a resection.- - - - - - - - - - ranking = 5keywords = adenocarcinoma, carcinoma (Clic here for more details about this article) |
6/136. Metastatic jejunal vipoma: beneficial effect of combination therapy with interferon-alpha and 5-fluorouracil.The vipoma syndrome is rare. It is usually caused by a neuroendocrine tumor located in the pancreas. somatostatin analogs and interferon-a can be helpful in the symptomatic control of the disease, but the efficacy of chemotherapy in metastatic disease is limited. We report the case of a 32-yr-old patient who had a primary intestinal vipoma with peritoneal carcinomatosis and hepatic metastases. somatostatin analogs and conventional chemotherapy regimens were not effective on vipoma syndrome and tumor progression. The combination of 5- fluorouracil and interferon-alpha was associated with a major clinical improvement and tumor regression. Further investigations should evaluate the place of such a combination as a first line treatment for patients with metastatic neuroendocrine tumors.- - - - - - - - - - ranking = 0.21163355566588keywords = carcinoma (Clic here for more details about this article) |
7/136. Malignant tumours of the small intestine: a case of jejunal adenocarcinoma.The Authors analyse the main problems concerning malignant tumours of the small intestine. They report a case of jejunal adenocarcinoma recently observed. They emphasise the importance of surgery, both diagnostic and therapeutic, even in advanced stages, for the treatment of this neoplasm.- - - - - - - - - - ranking = 5keywords = adenocarcinoma, carcinoma (Clic here for more details about this article) |
8/136. Pseudogastroparesis as a presentation of small-bowel malignancy.Establishing the diagnosis of small-bowel malignancy is sometimes an extremely difficult challenge owing to its non-specific symptoms. The mainstay of treatment is early recognition, diagnosis and surgical resection. The prognosis depends primarily on the degree of spread and stage at presentation. We present two cases with initially obscure presentations of a small-bowel tumour. One was a jejunal adenocarcinoma, but an initial upper gastrointestinal and small-bowel series did not disclose the lesion; the other was a primary ileal lymphoma, first thought to be diabetes mellitus gastroparesis. Therefore, a negative small-bowel series or presentation of a systemic disease-associated intestinal pseudo-obstruction or gastroparesis does not exclude the possibility of a small-bowel malignancy, if the clinical symptoms are not alleviated after prokinetic medications. The clinicians should further pursue the possibility of an obstructing lesion.- - - - - - - - - - ranking = 1keywords = adenocarcinoma, carcinoma (Clic here for more details about this article) |
9/136. Jejunal adenocarcinoma presenting as a primary ovarian carcinoma.OBJECTIVE: The aim of this case report was to evaluate the impact of immunohistochemical markers in diagnosing the primary site of adenocarcinoma in the abdominopelvic region. methods: Surgicopathologic data were obtained from laparotomy and necropsy. paraffin-embedded tissue from the ovary and jejunum was stained with hematoxylin and eosin, as well as with immunohistochemical stains for cytokeratin 20 and cytokeratin 7. RESULTS: A 53-year-old African American woman underwent an emergency laparotomy due to small bowel obstruction. During the operation, in addition to a complex adnexal mass as the cause of obstruction, a small solid jejunal tumor was also identified. Pathologic evaluation of the two sites demonstrated an infiltrating moderately to poorly differentiated adenocarcinoma with mucinous features. The malignant cells from both intestinal and ovarian sites showed immunoreactivity for cytokeratin 20 and revealed negative staining for cytokeratin 7. These results confirmed the diagnosis of intestinal primary with ovarian metastasis, which was initially misdiagnosed as an ovarian primary. CONCLUSION: Given the potential difficulty in determining the primary site of these tumors, immunohistochemistry proved to be a useful tool in reaching the correct diagnosis.- - - - - - - - - - ranking = 6.8465342226635keywords = adenocarcinoma, carcinoma (Clic here for more details about this article) |
10/136. Small bowel perforation caused by metastasis from an extra-abdominal malignancy: report of three cases.Small bowel perforation is rarely caused by metastasis from an extra-abdominal malignancy. This report describes three cases of small bowel perforation that occurred secondary to a metastatic tumor. The first case involved a 72-year-old man with malignant lymphoma of the larynx that had been treated with chemo- and radiation therapy; the second involved a 70-year-old man with rhabdomyosarcoma of the mediastinum that had been treated with radiation therapy; and the third involved a 41-year-old man with lung carcinoma that had been treated with surgery 10 months prior to perforation. Each patient presented with acute abdominal pain, had X-ray findings of free air in the abdomen, and underwent limited emergency surgery. Wedge resection and closure of the ileum was performed for the first patient and partial bowel resection with the creation of an intestinal stoma was performed for the second and third patients. In each case, the histologic findings of the resected specimens were consistent with the extra-abdominal primary tumors. Although the patients recovered sufficiently to begin eating and moving about, all three died of cancer or cancer-related complications within 45 days of surgery. We conclude that surgeons should be aware of the poor prognosis of such patients and perform only the minimal surgery required.- - - - - - - - - - ranking = 0.21163355566588keywords = carcinoma (Clic here for more details about this article) |
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