Small bowel adenocarcinoma (SBA) - A case report

Abstract

Backround. Small bowel cancers account for less than 0.5% of all malignancies and approximately 1-3% of gastrointestinal tract malignancies. The two major tumour types are carcinoid and adenocarcinoma. The latter is most commonly found in the duodenum and jejunum, but least often in the ileum. Case presentation. We present a case study of a 67-year-old woman with small bowel adenocarcinoma (SBA) of the ileum. The patient was admitted to the hospital with nonspecific, persistent, recurrent pain in her upper abdomen and with suspected subileus. Previously performed clinical investigation (i.e. colonoscopy, computed tomography scans - CT scans, small bowel follow-through) didn't reveal any abnormalities. At laparotomy we discovered a round mass obstructing the ileal lumen at about 40 cm from the Bauhin valve. A tumour was then resected within its surgical margins. Pathologic examination revealed an ileal adenocarcinoma and an infiltration of the local adipose tissue (Adenocarcinoma G3 partim gelatinosum), with no evidence of metastatic lesions in the lymph nodes nor into other organs (pT3N0M0; the clinical stage IIA). Further oncological treatment was thereby advised. Conclusions. A low prevalence and non-specific symptoms along without any clearly established diagnostic nor treatment protocols makes a final diagnosis difficult and thus merits further diagnostic investigation, particularly the testing of specific biochemical or immunological markers.