A Case of Locally Invasive Obstructive Jejunal Cancer with Curative Resection after Stenting and Chemotherapy

Hyung Ki Kim; Bong Min Ko; Jong Kyu Park; Su Jin Hong; Jong Ho Moon; Joon Seong Lee; Moon Sung Lee; Boo Sung Kim

doi:10.4166/kjg.2010.56.1.54

Journal List > Korean J Gastroenterol > v.56(1) > 1006758

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Kim, Ko, Park, Hong, Moon, Lee, Lee, and Kim: A Case of Locally Invasive Obstructive Jejunal Cancer with Curative Resection after Stenting and Chemotherapy

Original Article

Korean J Gastroenterol 2010;56(1):54-58.

Published online: 21 February 2010

DOI: https://doi.org/10.4166/kjg.2010.56.1.54

A Case of Locally Invasive Obstructive Jejunal Cancer with Curative Resection after Stenting and Chemotherapy

Hyung Ki Kim, M.D., Bong Min Ko, M.D., Jong Kyu Park, M.D., Su Jin Hong, M.D., Jong Ho Moon, M.D., Joon Seong Lee, M.D., Moon Sung Lee, M.D., Boo Sung Kim, M.D.

Department of Internal Medicine, Soon Chun Hyang University School of Medicine, Bucheon, Korea

Correspondence to: Bong Min Ko, M.D. Institude for Digestive Center, Department of Internal Medicine, Bucheon Hospital, Soonchunhyang University, 1174, Jung- dong, Wonmi-gu, Bucheon 420-767, Korea Tel: +82-32-621-5114, Fax: +82-32-621-5018 E-mail: kopa9445@schbc.ac.kr

Received 10 November 2009 Accepted 26 February 2010

Abstract

Small bowel adenocarcinoma is a relatively rare malignancy. In Korea, 13.1% of small bowel adenocarcinoma oc-curs in the jejunum. The absence of effective screening methods and relatively obscure symptoms contribute to the higher percentage of advanced cases at the time of diagnosis. Although curative resection is the mainstay of treatment, it is often impossible. Chemotherapy and radiotherapy have shown a disappointing treatment result for advanced staged small bowel adenocarcinoma. We report a 54-year-old woman with locally invasive jejunal cancer who underwent curative resection after stent insertion with enteroscopy and chemotherapy.

Keywords: Jejunal neoplasm, Stents, Chemotherapy

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Fig. 1.

(A) Endoscopically, the stomach showed surrounding edematous mucosa and central erosion with extrinsic compression on the posterior wall of the upper body. (B) Exophytic low density mass in the duodenum with direct in-vasion to the stomach and colon in the abdominal computed tomography. (C) Small bowel enteroscopy showed encircling ulcerating mass on the jejunum. (D) The jejunum biopsy indicated moderately differentiated adenocarcinoma (H&E stain, ×100).

Fig. 2.

(A) Stent was inserted on the jejunal obstruction site by push enteroscopy. (B) Abdominal computed tomograpy on the follow up showed markedly decreased size and invasiveness of jejunal cancer.

Fig. 3.

The jejunal specimen after jejunal segmental resection showed marked fibrosis, necrosis, and chronic inflammation without re-sidual cancer (H&E stain, A: ×20, B: ×100).

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