Title: Ileal Adenocarcinoma – A Case Report

Authors: Dr M M Litake, Dr Shrinath

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i10.121

Abstract

Small bowel malignancies are a rare clinical entity and accounts for only 1-3% of GI malignancies. Adenocarcinoma is the most common histopathological variety but its frequency decreases at distal locations. Most of small bowel neoplasms are asymptomatic until they become large and hence delay the diagnosis.

We report a case of an ileal adenocarcinoma in a 65 year old male patient who presented with complains of pain abdomen and vomiting since 5 days. Investigations revealed small bowel obstruction. On exploration it was found to be ileal mass. Right hemicolectomy was done with en-bloc removal of distal ileal mass. Histopathology revealed ileal adenocarcinoma.

This rare entity is associated with a nonspecific clinical presentation that contributes to delayed diagnosis and treatment, and consequently to a worse prognosis. Approximately half of the cases are only diagnosed at surgery. Primary treatment consists of wide resection with regional lymphadenectomy. The role of adjuvant chemotherapy has yet to be determined.

This case demonstrates an unusual condition characterized by late and challenging diagnosis and we highlight the importance of an earlier diagnosis and optimal treatment for improved patient outcomes.

References

  1. Schwartz principles of surgery 20th edition 2015;1159-1162.
  2. Agarwal S, McCarron EC, Gibbs JF, Nava HR, Wilding GE, Rajput A. Surgical management and outcome in primary adenocarcinoma of small bowel. Ann Surg Oncol.2007; 14;2263 .
  3. Celso Nabais, Raquel Salústio, Francisco V. Sousa, Eusébio Porto, Carlos Cardoso, and Caldeira Fradique; Adenocarcinoma of the ileum: A rare and challenging entity; Ann Med Surg (Lond). 2015 Jun; 4(2): 116–118.
  4. Overman, M.J., Kopetz, S., Lin, E., Abbruzzese, J.L., Wolff, R.A. Is there a role for adjuvant therapy in resected adenocarcinoma of the small intestine. Acta Oncol. 2010;49:474–479.
  5. Halfdanarson, T.R., McWilliams, R.R., Donohue, J.H., Quevedo, J.F. A single-institution experience with 491 cases of small bowel adenocarcinoma. Am J Surg. 2010;199:797–803.
  6. Shenoy S. Primary small-bowel malignancy: update in tumor biology, markers, and management strategies. J Gastrointest Cancer. 2014;45(4):421–430.

Corresponding Author

Dr Shrinath

B.J.G.M.C