Korean J Gastroenterol.  2011 Oct;58(4):217-220. 10.4166/kjg.2011.58.4.217.

Small Bowel Carcinoma in Young Patient Detected by Double-balloon Enteroscopy

Affiliations
  • 1Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea. sungwoojung@korea.ac.kr
  • 2Department of Surgery, Korea University College of Medicine, Seoul, Korea.
  • 3Department of Pathology, Korea University College of Medicine, Seoul, Korea.

Abstract

A 17-year old female presented with a chief complaint of melena and epigastric pain. She had a family history of colon cancer, her mother having been diagnosed with hereditary nonpolyposis colorectal carcinoma (HNPCC). After close examination including double-balloon enteroscopy, the patient was diagnosed with small bowel carcinoma, in spite of her young age. Here we report this rare case of small bowel carcinoma in a young patient with a family history of HNPCC.

Keyword

Jejunal neoplasm; Hereditary nonpolyposis colon cancer; Double-balloon enteroscopy

MeSH Terms

Adenocarcinoma/*diagnosis/pathology/surgery
Adolescent
Double-Balloon Enteroscopy
Female
Humans
Jejunal Neoplasms/*diagnosis/pathology/surgery
Positron-Emission Tomography
Tomography, X-Ray Computed

Figure

  • Fig. 1. Abdominal CT finding. It revealed segmental eccentric wall thickening of the jejunum which indicated a pathology of lymphoma or adenocarcinoma.

  • Fig. 2. Endoscopic finding. A large cancerous lesion with friable bleeding mucosa was found in the proximal jejunum that almost obstructed the bowel.

  • Fig. 3. PET scan finding. It revealed that the jejunal mass showed intense hypermetabolism. There were no other abnormal metabolic lesions.

  • Fig. 4. Gross finding of the jejunal segmentectomy specimen. There was 9.0×5.5 cm mass involving the proximal jejunum.

  • Fig. 5. Pathologic finding. (A) Well differentiated adenocarcinoma extended to the muscle layer and periintestinal adipose tissue of jejunum (H&E,×12.5). (B) Proliferation of atypical glands with irregular contours. The adenocarcinoma invaded the adjacent tissue with necrosis (H&E, ×100).


Reference

References

1. Aarnio M, Mecklin JP, Aaltonen LA, Nyström-Lahti M, Järvinen HJ. Lifetime risk of different cancers in hereditary non-polyposis colorectal cancer (HNPCC) syndrome. Int J Cancer. 1995; 64:430–433.
Article
2. Hampel H, Stephens JA, Pukkala E, et al. Cancer risk in hereditary nonpolyposis colorectal cancer syndrome: later age of onset. Gastroenterology. 2005; 129:415–421.
Article
3. Lindor NM, Petersen GM, Hadley DW, et al. Recommendations for the care of individuals with an inherited predisposition to Lynch syndrome: a systematic review. JAMA. 2006; 296:1507–1517.
4. Anaya DA, Chang GJ, Rodriguez-Bigas MA. Extracolonic manifestations of hereditary colorectal cancer syndromes. Clin Colon Rectal Surg. 2008; 21:263–272.
Article
5. Lynch HT, Smyrk TC, Lynch PM, et al. Adenocarcinoma of the small bowel in lynch syndrome II. Cancer. 1989; 64:2178–2183.
Article
6. Schulmann K, Engel C, Propping P, Schmiegel W. Small bowel cancer risk in Lynch syndrome. Gut. 2008; 57:1629–1630.
Article
7. Winawer S, Fletcher R, Rex D, et al. Gastrointestinal Consortium Panel. Colorectal cancer screening and surveillance: clinical guidelines and rationale-Update based on new evidence. Gastroenterology. 2003; 124:544–560.
Article
8. Rodriguez-Bigas MA, Vasen HF, Lynch HT, et al. Characteristics of small bowel carcinoma in hereditary nonpolyposis colorectal carcinoma. International Collaborative Group on HNPCC. Cancer. 1998; 83:240–244.
9. Schulmann K, Brasch FE, Kunstmann E, et al. German HNPCC Consortium. HNPCC-associated small bowel cancer: clinical and molecular characteristics. Gastroenterology. 2005; 128:590–599.
Article
10. Baichi MM, Arifuddin RM, Mantry PS. Metachronous small bowel adenocarcinomas detected by capsule endoscopy in a patient with hereditary nonpolyposis colorectal cancer. Dig Dis Sci. 2007; 52:1134–1136.
Article
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