Incidentally Detected Small Intestine Intussusception Caused by Primary Small Intestine Carcinoma on ¹⁸F-FDG PET/CT / 대한핵의학회잡지

Small intestine intussusception in adults is a rare condition mainly caused by primary or metastatic small intestine malignancy. Here, we present a 72-year-old male patient who was diagnosed with small intestine cancer that was presented as small intestine intussusception on hybrid 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT). The patient was initially referred for an abnormality on a chest radiography and severe anemia. FDG PET/CT showed the lung lesion in the right upper lobe of lung as a high FDG uptake mass. Accidentally, FDG PET demonstrated another intense hypermetabolic intraluminal lesion in the small intestine accompanied with intussusception shown as a circumferential hypermetabolic wall. By pathologic examination, the patient was diagnosed as primary small intestine cancer with lung metastasis. This case highlights usefulness of hybrid FDG PET/CT to identify unexpected malignancy.

Palliative care for an AIDS patient with small intestine cancer

<b>Introduction：</b>Patients with AIDS are considered appropriate for the admission to the inpatient palliative care unit（PCU）, but in reality, many facilities do not accept them. Furthermore, it is rare to see a patient with AIDS with complication of small intestinal adenocarcinoma. We report a case of our experience treating such patient at the PCU／hospice unit of our facility. <b>Case：</b>A 64 years old male patient, receiving a treatment with antiviral drug for AIDS diagnosis, was referred to our hospital for the admission to PCU due to the complication of small intestinal cancer. We treated his increased pain with the combination use of fentanyl patch and morphine continuous subcutaneous infusion, which successfully controled the symptom. During his final days, we had him on sedation upon his request；initiated from the intermittent sedation followed by continuous deep sedation using Phenobal. <b>Discussion：</b>Considering the aging society, the number of people with HIV／AIDS in need of palliative care would also be on the rise. Through close communication among facilities and pre-admission preparation to accommodate special needs those patients may have, palliative care units may be able to accept more people with HIV／AIDS.