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

Yoon Ji Choi; Sung Woo Jung; Jun Won Um; Eung Seok Lee; Ja Seol Koo; Hyung Joon Yim; Sang Woo Lee; Jai Hyun Choi

doi:10.4166/kjg.2011.58.4.217

Journal List > Korean J Gastroenterol > v.58(4) > 1006866

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Choi, Jung, Um, Lee, Koo, Yim, Lee, and Choi: Small Bowel Carcinoma in Young Patient Detected by Double-balloon Enteroscopy

Case Report

Korean J Gastroenterol 2011;58(4):217-220.

Published online: 4 October 2011

DOI: https://doi.org/10.4166/kjg.2011.58.4.217

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

Yoon Ji Choi, Sung Woo Jung, Jun Won Um¹, Eung Seok Lee², Ja Seol Koo, Hyung Joon Yim, Sang Woo Lee, Jai Hyun Choi

Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea

¹Department of Surgery, Korea University College of Medicine, Seoul, Korea

²Department of Pathology, Korea University College of Medicine, Seoul, Korea

Correspondence to: Sung Woo Jung, Division of Gastroenterology, Department of Internal Medicine, Korea University Ansan Hospital, 516, Gojan 1-dong, Danwon-gu, Ansan 425-707, Korea. Tel: +82-31-412-4854, Fax: +82-31-412-5582, E-mail: sungwoojung@korea.ac.kr

Received 15 October 2010 Accepted 16 December 2010

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Jejunal neoplasm, Hereditary nonpolyposis colon cancer, Double-balloon enteroscopy

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.

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.

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.

5. Lynch HT, Smyrk TC, Lynch PM, et al. Adenocarcinoma of the small bowel in lynch syndrome II. Cancer. 1989; 64:2178–2183.

6. Schulmann K, Engel C, Propping P, Schmiegel W. Small bowel cancer risk in Lynch syndrome. Gut. 2008; 57:1629–1630.

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.

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.

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.

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).

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