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.

scholarly journals Bevacizumab in metastatic small-bowel adenocarcinoma: A systematic review and meta-analysis

Rare Tumors ◽  
2019 ◽  
Vol 11 ◽  
pp. 203636131882541 ◽  
Author(s):  
John Paulo Vergara ◽  
Danielle Benedict Leoncio Sacdalan ◽  
Madelaine Amurao-Amante ◽  
Dennis Lee Sacdalan
Keyword(s):  
Systematic Review ◽  
Small Bowel ◽  
Meta Analysis ◽  
Objective Response ◽  
Progression Free Survival ◽  
Small Bowel Adenocarcinoma ◽  
Gastrointestinal Malignancies ◽  
Histologic Subtype ◽  
Vascular Epithelial Growth Factor ◽  
American Society

Cancers of the small bowel could account for less than 5% of all gastrointestinal malignancies. Of these tumors, adenocarcinomas were the major histologic subtype and generally carried a poor prognosis. High expression of vascular epithelial growth factor (VEGF) could be seen in small bowel adenocarcinomas. A systematic review was conducted here to determine if bevacizumab, a recombinant humanized antibody against VEGF, could offer clinical benefit among patients with metastatic small bowel adenocarcinoma when combined with chemotherapy. A search for relevant published and unpublished studies was performed using PubMed, ScienceDirect, Google Scholar, the American Society of Clinical Oncology meetings library, ClinicalTrials.gov, and ISRCTN registry. Information on study design, methods, intervention, and outcomes were extracted from selected eligible studies. Methodological quality was then assessed using the Newcastle-Ottawa Scale. There was a significant improvement in mean overall survival with the addition of bevacizumab with chemotherapy versus chemotherapy alone. The use of bevacizumab with chemotherapy, likewise improved progression-free survival and objective response rate compared to chemotherapy alone. Continued use of bevacizumab beyond first progression also appeared to show benefit. The conduct of prospective controlled studies by consortia to offset the rarity of small bowel adenocarcinomas could further elucidate the efficacy of bevacizumab in the treatment of this disease.

Are Ovaries a Sanctuary for Lymphoma? Report of a Cure of Recurrent Lymphoma in Both Ovaries after Bilateral Oophorectomy.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4653-4653
Author(s):  
A. Majid Shojania ◽  
J. Kelly MacDonald
Keyword(s):  
Small Bowel ◽  
Ct Scan ◽  
Disease Free Survival ◽  
Pathology Report ◽  
Fallopian Tubes ◽  
Bilateral Oophorectomy ◽  
Lymphoma Cells ◽  
Free Survival ◽  
Poorly Differentiated ◽  
Disease Free

Abstract Isolated bilateral ovarian lymphoma is extremely rare. Those reported are generally due to aggressive lymphoma and are associated with a poor outcome. We present a case of low grade abdominal lymphoma which had been treated with bowel resection and chemotherapy. The patient subsequently developed recurrence of lymphoma in both ovaries and underwent bilateral oophorectomy. She has remained free of lymphoma for 10 years without any therapy for lymphoma. Case report: A Caucasian female was born in 1940. In July 1985, she underwent a surgical removal of a large mesenteric mass and a 72 cm length of small bowel. The pathology report indicated the involvement of small bowel, mesenteric nodes and mesenteric fat with: Diffuse poorly differentiated lymphocytic lymphoma (Rappoport), malignant lymphoma, follicular and diffuse, predominantly small cleave cells with focal sclerosis (working formulation). She was treated with chlorambucil until July 1992 when because of leucopenia, chemotherapy was discontinued. CT scan of the abdomen in August 1992 was normal. In August 1995, she presented with acute abdominal pain. She underwent a resection of both ovaries, of the Fallopian tubes and of the uterus. The pathology report indicated that both ovaries were involved with: Malignant lymphoma, lymphocytic, poorly differentiated, partly nodular. The Fallopian tubes and the uterus did not show any lymphoma. A post-operative bone marrow biopsy and a CT of the chest and abdomen did not show any abnormality. Because there was no evidence of residual lymphoma, no therapy was offered after the operation. She has remained disease free 10 years after resection of the ovaries. The CT scan of the chest and abdomen in May 2004 were normal. Because of the unusual course of the disease and long-term disease free survival post recurrence, all of the pathological specimens were reexamined and were found to be similar microscopically and immunohistochemically. The tumors of small bowel, mesentery, omentum as well as both ovaries were reclassified in modern terminology as: Follicular lymphoma, Grade 1. The tumors have a similar appearance in that they are composed predominantly of poorly formed nodules of lymphoma with diffuse area. They have similar immunohistochemical profiles. They are faintly positive for CD20, CD22, CD10 and strongly positive for Bcl-2. Both tumors are negative for CD43 and CD45RO. Conclusion: There are two possibilities for why isolated bilateral lymphoma may have developed in this case. One is that the lymphoma of the ovaries in this case was a second lymphoma unrelated to the initial lymphoma of the bowel and mesentery. If this is the case, the identical features of the two tumors and the simultaneous appearance in both ovaries, sparing other tissues is extremely unusual. The second possibility is that the ovaries provided a sanctuary for the original lymphoma cells. The resection of the original tumor followed by chemotherapy, had destroyed all of the lymphoma cells in the other organs. But the ovaries had provided a sanctuary for the lymphoma cells, allowing them to grow locally. Removal of the ovaries provided a 10 year disease free survival.

A Rare Case of Primary Small Bowel Adenocarcinoma with Intussusception

2010 ◽  
Vol 96 (2) ◽  
pp. 355-357 ◽  
Author(s):  
Stefano Caruso ◽  
Daniele Marrelli ◽  
Corrado Pedrazzani ◽  
Alessandro Neri ◽  
Maria Antonietta Mazzei ◽  
...  
Keyword(s):  
Small Bowel ◽  
Rare Case ◽  
Small Bowel Adenocarcinoma ◽  
Primary Small Bowel

scholarly journals Small bowel adenocarcinoma: a case of atypical CT scan appearance

2012 ◽  
Vol 2012 (jun08 1) ◽  
pp. bcr0220125915-bcr0220125915
Author(s):  
A. M. Eltweri ◽  
D. Bowrey ◽  
M. Taylor
Keyword(s):  
Small Bowel ◽  
Ct Scan ◽  
Small Bowel Adenocarcinoma

scholarly journals S2874 A Rare Case of Invasive Small Bowel Adenocarcinoma in a Patient With Celiac Disease

2020 ◽  
Vol 115 (1) ◽  
pp. S1450-S1450
Author(s):  
Aida Rezaie ◽  
Nael Haddad ◽  
Sakolwan Suchartlikitwong ◽  
Paul Muna Aguon ◽  
Anam Omer ◽  
...  
Keyword(s):  
Celiac Disease ◽  
Small Bowel ◽  
Rare Case ◽  
Small Bowel Adenocarcinoma

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 Bowel Adenocarcinoma: Is There a Difference in Survival for Crohn's Versus Sporadic Cases?

2019 ◽  
Vol 14 (3) ◽  
pp. 303-308 ◽  
Author(s):  
Adam C Fields ◽  
Frances Y Hu ◽  
Pamela Lu ◽  
Jennifer Irani ◽  
Ronald Bleday ◽  
...  
Keyword(s):  
Overall Survival ◽  
Risk Factor ◽  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Small Bowel Adenocarcinoma ◽  
Younger Age ◽  
Sporadic Cases ◽  
Poorly Differentiated ◽  
The Impact

Abstract Background and Aims It is well known that Crohn's disease is a risk factor for the development of small bowel adenocarcinoma. However, the association between Crohn's disease-associated small bowel adenocarcinoma and survival is less understood. The goal of this study was to determine the impact of Crohn's disease on survival in small bowel adenocarcinoma. Methods Patients with small bowel adenocarcinoma, either associated with Crohn's disease or diagnosed sporadic, were identified in the National Cancer Database from 2004–2016. The primary outcome was overall survival. Results Of 2668 patients, 493 had Crohn's disease-associated small bowel adenocarcinoma and 2175 had sporadic small bowel adenocarcinoma. Crohn's disease patients were more likely to present at a younger age [62 vs 65, p &lt; 0.001], have tumours located in the ileum [62.7% vs 25.0%, p &lt; 0.001], and have poorly differentiated tumours [47.0% vs 31.7%, p &lt; 0.001] compared with sporadic small bowel adenocarcinoma. Factors associated with significantly decreased survival included older age (hazard ratio [HR]: 1.02, 95% confidence interval [CI]: 1.02–1.03, p &lt; 0.00)], higher Charlson score [HR: 1.39, 95% CI: 1.13–1.72, p = 0.002], higher tumour grade [HR: 1.09, 95% CI: 1.04–1.14, p &lt; 0.001], positive surgical margins [HR: 1.60, 95% CI: 1.39–1.84, p &lt; 0.001], and higher stage of disease [HR: 1.90, 3.75, 8.13, 95% CI: 1.37–2.64, 2.68–5.24, 5.77–11.47, for II, III, IV, respectively, compared with I, all p &lt; 0.001]. Receipt of chemotherapy was associated with significantly improved survival [HR: 0.61, 95% CI: 0.53–0.70, p &lt; 0.001]. Crohn's disease [HR: 1.01, 95% CI: 0.99–1.02, p = 0.39], was not significantly associated with survival. Conclusion Compared with sporadic patients, Crohn's disease patients have similar overall survival, and Crohn's disease is not an independent risk factor for mortality.

Small bowel adenocarcinoma treatment: A single centre experience.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 451-451
Author(s):  
Philip Bredin ◽  
Joseph J McKendrick ◽  
Prasad Cooray ◽  
Rachel Wong
Keyword(s):  
Small Bowel ◽  
Early Stage ◽  
Eastern Health ◽  
Small Bowel Adenocarcinoma ◽  
Curative Intent ◽  
Early Stage Disease ◽  
Gastrointestinal Malignancies ◽  
Free Survival ◽  
Line Chemotherapy

451 Background: Small bowel adenocarcinoma (SBA) has a high mortality. Randomised controlled trials are not feasible due to its rarity, therefore there is no gold standard treatment approach. Surgical resection for early stage disease is the only potentially curative option. Systemic therapeutic options are generally extrapolated from oesophagogastric and colorectal chemotherapy regimens. Methods: This is a retrospective review of treatment and outcomes for SBA patients who attended Eastern Health between 1st January 2010 and 30thJune 2015. Approval was obtained from the Eastern Health Human Research and Ethics Committee. Results: Thirty-six patients with SBA were identified: 16 (44%) duodenal, 12 (33%) ampullary, 6 (17%) jejunal, 2 (6%) terminal ileum, 1 not specified. Median age was 72 and 25 (69%) were male. Stage at diagnosis was as follows: Stage 1 = 4 (11%), Stage 2 = 8 (22%), Stage 3 = 9 (25%) and Stage 4 = 10 (28%). Surgery with curative intent occurred in 19 patients (Whipple’s = 13, wide local excision = 6) of whom 6 received adjuvant (predominantly fluoropyrimidine-based) chemotherapy. One patient died from post-operative complications. At last follow-up, 8 patients remained in complete remission; 11 had relapsed; 3 were lost to follow-up. Three patients had died due to disease. Median relapse-free survival in the curative-intent group was 21.4 months. Median overall survival (OS) has not been reached. Sixteen patients were initially treated with palliative intent. Ten underwent palliative surgery (bypass = 7; resection = 3). Overall, 16 patients commenced palliative chemotherapy, including 8 from the curative-intent group post-relapse. The most commonly used regimen was oxaliplatin plus fluoropyrimidine. Best responses to chemotherapy were partial response = 5 (31%) and stable disease = 4 (25%). Six patients received second-line chemotherapy. Median progression-free survival on first-line chemotherapy was 4.8 months. Median OS was 9.4 months. Conclusions: SBA has a poor prognosis. Although 56% of advanced SBA patients had disease control using chemotherapy extrapolated from other gastrointestinal malignancies, responses were not durable.

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