scholarly journals A rare case of jejunal adenocarcinoma with brain metastasis

2021 ◽  
Author(s):  
M. Harish ◽  
N. Hariprasad ◽  
R. Kannan
Keyword(s):  
Lymph Node ◽  
Small Bowel ◽  
Brain Metastasis ◽  
Delayed Diagnosis ◽  
Late Presentation ◽  
Lower Limbs ◽  
Jejunal Loop ◽  
Wall Thickening ◽  
Small Bowel Adenocarcinoma ◽  
Regional Lymphadenectomy

Small bowel malignancies are rare entity, with adenocarcinoma being one of common type along with neuroendocrine tumours. Associated with Crohns, celiac disease, FAP and HNPCC. Jejunal adenocarcinoma produce vague symptoms, accounting for late presentation leading to difficult and delayed diagnosis in favour of poor prognosis. Diagnosis is established by CECT abdomen and CEA levels. Ro resection with regional lymphadenectomy and jejunojejunal anastomosis is preferred followed by adjuvant FOLFOX chemotherapy. Here we presenting a 68 years old male, anaemic with vague abdominal pain for 3 months, CECT showed malignant wall thickening involving 10 cm of proximal jejunal loop with no enlarged lymph nodes and CEA was elevated. Proceeded with laparotomy, an irregular hard mass of 10×10 cm involving 20 cm of jejunum with transverse colon infiltration with multiple mesenteric nodes found, composite resection with jejunojejunostomy and colocolic anastomosis done. Histopathology showed poorly differentiated jejunal adenocarcinoma with colonic infiltration with reactive nodes and post operatively on day 7, patient developed seizures and weakness of left upper and lower limbs, MRI brain showed solitary metastasis 2×2 cm in right frontal region and PET CT showed brain metastasis and multiple intraabdominal lymph node, lung and prostate metastasis, planned SBRT for brain metastasis and palliative chemotherapy. Lymph node, liver and peritoneum are common site of metastasis for small bowel adenocarcinoma, very rarely brain metastasis can occur in short time and to be considered if neurological symptoms occur pre and postoperatively.

Small Intestine: Adenocarcinoma

2017 ◽  
Author(s):  
Joel M Baumgartner ◽  
Sudeep Banerjee ◽  
Jason K Sicklick
Keyword(s):  
Lymph Node ◽  
Small Bowel ◽  
Systemic Chemotherapy ◽  
Imaging Techniques ◽  
Distant Metastases ◽  
Lymph Node Involvement ◽  
Small Bowel Adenocarcinoma ◽  
Stage Disease ◽  
Node Involvement ◽  
Inflammatory Bowel

Adenocarcinoma is the second most common nonduodenal small bowel tumor. Small bowel adenocarcinoma has risk factors similar to those of colorectal adenocarcinoma but is rarer and less well understood. Diagnosis relies on advanced imaging techniques as well as endoscopy or enteroscopy for tissue diagnosis. Aggressive biology and vague symptoms in early disease cause a majority of patients to present with late-stage disease. Adenocarcinomas with lymph node involvement should be treated with resection and systemic chemotherapy. In contrast, systemic chemotherapy alone should be employed in cases with distant metastases unless the primary tumor is bleeding, perforated, or causing a bowel obstruction.   This review contains 4 figures, 5 tables and 17 references Key words: adenocarcinoma, chemotherapy, enteroscopy, hereditary syndrome, inflammatory bowel disease, lymph node, mesentery, small bowel  

Small Intestine: Adenocarcinoma

2017 ◽  
Author(s):  
Joel M Baumgartner ◽  
Sudeep Banerjee ◽  
Jason K Sicklick
Keyword(s):  
Lymph Node ◽  
Small Bowel ◽  
Systemic Chemotherapy ◽  
Imaging Techniques ◽  
Distant Metastases ◽  
Lymph Node Involvement ◽  
Small Bowel Adenocarcinoma ◽  
Stage Disease ◽  
Node Involvement ◽  
Inflammatory Bowel

Adenocarcinoma is the second most common nonduodenal small bowel tumor. Small bowel adenocarcinoma has risk factors similar to those of colorectal adenocarcinoma but is rarer and less well understood. Diagnosis relies on advanced imaging techniques as well as endoscopy or enteroscopy for tissue diagnosis. Aggressive biology and vague symptoms in early disease cause a majority of patients to present with late-stage disease. Adenocarcinomas with lymph node involvement should be treated with resection and systemic chemotherapy. In contrast, systemic chemotherapy alone should be employed in cases with distant metastases unless the primary tumor is bleeding, perforated, or causing a bowel obstruction.   This review contains 4 figures, 5 tables and 17 references Key words: adenocarcinoma, chemotherapy, enteroscopy, hereditary syndrome, inflammatory bowel disease, lymph node, mesentery, small bowel  

Delayed diagnosis of small bowel obstruction following laparoscopic lymph node dissection

2002 ◽  
Vol 23 (3) ◽  
pp. 243-246 ◽  
Author(s):  
Shawn Van Deusen ◽  
Robert H Birkhahn ◽  
Theodore J Gaeta ◽  
Joseph J Bove
Keyword(s):  
Lymph Node ◽  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Lymph Node Dissection ◽  
Bowel Obstruction ◽  
Delayed Diagnosis ◽  
Node Dissection

scholarly journals Small bowel adenocarcinoma: revisited

2021 ◽  
Vol 8 (3) ◽  
pp. 1010
Author(s):  
Muhammad F. Rosley ◽  
Mahanama Dissanayake
Keyword(s):  
Adjuvant Chemotherapy ◽  
Small Bowel ◽  
Metabolic Response ◽  
Advanced Disease ◽  
Tumor Staging ◽  
Delayed Diagnosis ◽  
Small Bowel Resection ◽  
Anatomical Location ◽  
Small Bowel Adenocarcinoma ◽  
Presenting Symptoms

Small bowel malignancies are rare despite it representing 75% of the gastro intestinal (GI) length and 90% of the mucosal surface area. Even then small bowel adenocarcinoma (SBA) accounts for only 30-40% of all small intestine malignancies. Etiology is multifactorial and risk factors include hereditary mutations, inflammatory bowel diseases, coeliac disease. Presenting symptoms are vague and nonspecific and cannot usually be diagnosed by conventional upper and lower GI endoscopy as it is in an inaccessible location. This leads to delayed diagnosis and hence poor prognosis. Mainstay of treatment is surgical resection with adjuvant chemotherapy in advanced disease. We present a case study of a 74 years old woman who presented to the emergency department with small bowel obstruction and radiological features suggestive of underlying small bowel malignancy. She underwent urgent laparotomy with segmental small bowel resection and had intraoperative evidence of wide spread metastasis which was confirmed on subsequent tumor staging scans. She received adjuvant chemotherapy with complete metabolic response at one year post resection. SBA is generally diagnosed at advanced stage due to its anatomical location. Complete surgical resections should always be targeted. However, adjuvant chemotherapy plays a role in advanced disease even though clinical data of evidence is scarce.

scholarly journals Prognostic value of lymph node evaluation in small bowel adenocarcinoma

Cancer ◽  
2010 ◽  
Vol 116 (23) ◽  
pp. 5374-5382 ◽  
Author(s):  
Michael J. Overman ◽  
Chung-Yuan Hu ◽  
Robert A. Wolff ◽  
George J. Chang
Keyword(s):  
Lymph Node ◽  
Small Bowel ◽  
Prognostic Value ◽  
Small Bowel Adenocarcinoma ◽  
Lymph Node Evaluation

scholarly journals A rare case of brain metastasis from poorly differentiated small bowel adenocarcinoma

2019 ◽  
Vol 10 ◽  
pp. 256
Author(s):  
Erika Yamazawa ◽  
Yoshitaka Honma ◽  
Kaishi Satomi ◽  
Hirokazu Taniguchi ◽  
Masamichi Takahashi ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Small Bowel ◽  
Brain Metastasis ◽  
Ct Scan ◽  
Rare Case ◽  
Clinical Course ◽  
Small Bowel Adenocarcinoma ◽  
Gastrointestinal Malignancies ◽  
Abdominal Lymph Node ◽  
Poorly Differentiated

Background: Small bowel adenocarcinoma (SBA) accounts for <2% of all gastrointestinal malignancies. The most common organs of SBA metastases are the abdominal lymph node, liver, and peritoneum. There have been almost no reports of brain metastases of SBA. Dabaja et al. reported 1 case of brain metastasis out of 217 SBA cases, but details of the clinical course of the case were unclear. Our case might be the first report covering the full clinical course, pathological findings, and genetic data. Here, we report a very rare case of brain metastasis from poorly differentiated SBA. Case Description: A 54-year-old man who suffered from abdominal pain and melena visited a nearby hospital. This patient had no risk factors for SBA. He underwent partial resection of the jejunum with regional lymphadenectomy and combined resection of the transverse colon. Pathological diagnosis was poorly differentiated adenocarcinoma, pT4N2M0 Stage IIIB (UICC-TNM: 8th edition). One month after curative surgery, liver metastasis was detected by a computed tomography (CT) scan, and then, palliative chemotherapy was started. During the third-line chemotherapy, a brain tumor on the left cerebellum was detected by the CT scan. Tumor resection was performed, and the histopathological features coincided with the primary jejunum tumor. Based on surgical, radiological, pathological, and genetic findings, this brain tumor was comprehensively diagnosed as a metastasis from poorly differentiated SBA. Conclusion: Here, we experienced a very rare case of brain metastasis from poorly differentiated SBA.

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