Primary adenocarcinoma of the jejunum and ileum: clinicopathological review of 25 cases

Article Abstract:

Although the small intestine accounts for three quarters of the gastrointestinal tract, cancers of the small intestine are rare, accounting for from 1 to 5 percent of gastrointestinal tumors. Most of these are found in the duodenum, near the junction of the stomach. In one series of 84 cases of adenocarcinoma of the small intestine, seen over a period of 34 years, 70 percent of the cases involved the duodenum and the periampullary region (the ampulla is the dilation where the bile duct meets the pancreatic duct prior to emptying into the duodenum). Of the 25 cases involving the remainder of the small intestine, 14 were located in the jejunum and 11 were located in the ileum. Cancers of the jejunum and ileum tend to have a distinct course from cancers of the duodenum and the ampulla, and so are considered separately. Unfortunately, the location of these cancers generally results in a poor outcome. Early detection is rare, and the tumors are not accessible to examination with the endoscope (an optical device used for examining the stomach). In the present series, only 15.7 percent of the patients were alive after five years. It is worth noting that all the survivors had cancers located in the jejunum. The grade of the tumor and the size of the tumor had little effect on survival; the important prognostic factor was the degree to which the cancer had invaded the surrounding tissue. As is the case with adenocarcinoma of the large intestine, cancers of the small intestine are frequently associated with villous adenoma. A villous adenoma is a tumor of the intestinal lining with a distinct, almost cauliflower-like appearance. They seem to transform into malignant cancers with high frequency; some investigators estimate half undergo malignant transformation. These tumors generally make their presence known by symptoms of intestinal obstruction, and the only treatment is surgical; postoperative chemotherapy has little or no effect on survival. (Consumer Summary produced by Reliance Medical Information, Inc.)

Adenocarcinoma

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Primary squamous cell carcinoma of the terminal ileum

Article Abstract:

The case is described of a man who developed squamous cell carcinoma, a type of cancer, in the terminal ileum, which is the lower part of the small intestine that connects with the upper portion of the large intestine, or colon. The patient was a 62- year-old man evaluated for a one-year history of intermittent crampy abdominal pain and vomiting. The tumor was diagnosed and then removed surgically by cutting out the ileum and part of the adjacent colon, and reattaching the remaining pieces of intestine (a procedure known as end-to-end anastomosis). The patient recovered without complications and was well three years later. His case was unusual because of the way the cancer apparently developed. Squamous cell carcinoma of the small intestine usually develops as a metastasis (spreading of tumor) from other sites in the body. It is rare for this type of cancer to originate in the small intestine as a primary tumor. This patient's cancer was also unusual in that it could not be explained by an underlying inflammatory condition, or an underlying adenoma (tumor of the glandular epithelium), as neither condition was found. Details of the pathogenesis (pathological beginning) of the tumor are discussed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Development and progression, Gastrointestinal cancer, Digestive system cancer

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Squamous cell carcinoma arising in endometriosis of the ovary

Article Abstract:

The occurrence of squamous cell carcinoma developing from endometriosis (abnormal growth of uterine tissue) in the ovary is very rare. Squamous cell carcinomas can arise from other pre-existing tumors in the ovary, including a mature teratoma or a Brenner tumor. A case is reported of a 62-year-old post-menopausal women who had cancer in her ovary which was diagnosed as a squamous cell carcinoma. There was evidence that the women previously had endometriosis in the ovary. It is possible that the cancer can develop from this benign condition. The cancer had spread into the underlying muscle of the uterus, and there was no evidence of squamous cell carcinoma in other parts of the uterus. Therefore, the squamous cell carcinoma of the ovary did not appear to come from other areas. Squamous cell carcinoma of the uterus is very serious and this patient died within three months of surgery and treatment with chemotherapy, due to spread of the cancer. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Diagnosis, Complications and side effects, Endometriosis, Ovarian tumors

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