ABSTRACT
Jejunal adenocarcinoma is rare, often presenting late with widespread intraperitoneal disease. Intraperitoneal chemotherapy (IPC) has been shown in non-randomized studies to improve the survival of patients presenting with intraperitoneal metastases from carcinoma of the colon, appendix and stomach and in primary peritoneal malignancies including mesothelioma and pseudomyxoma peritonei, providing that adequate operative cytoreduction can be performed. A case is presented of obstructive jejunal adenocarcinoma in which 19 intraperitoneal deposits were excised. The patient was treated successfully with immediate postoperative IPC followed by systemic chemotherapy. This condition is reviewed along with the rationale for IPC.
El adenocarcinoma del yeyuno es raro, presentándose a menudo de forma tardía con enfermedad intraperitoneal extensa. Estudios no randomizados han demostrado que la quimioterapia intraperitoneal (QIP) mejora la supervivencia de pacientes que presentan metástasis intraperitoneal del carcinoma de colon, apéndice y estómago, así como en malignidades peritoneales primarias, incluyendo el mesotelioma y el pseudomixoma peritoneal, siempre que se realice una adecuada citoreducción quirúrgica. Se presenta un caso de adenocarcinoma yeyunal obstructivo en el que se extirparon 19 depósitos del intraperitoneal, tratándose inmediatamente al paciente exitosamente con quimioterapia intraperitoneal postoperatoria, seguida de quimioterapia sistémica. Se examina esta condición junto con las razones para practicar la QIP.
Subject(s)
Humans , Male , Middle Aged , Adenocarcinoma/drug therapy , Adenocarcinoma/surgery , Peritoneal Neoplasms/drug therapy , Peritoneal Neoplasms/surgery , Jejunal Neoplasms/drug therapy , Jejunal Neoplasms/surgery , Antineoplastic Combined Chemotherapy Protocols , Adenocarcinoma/pathology , Fluorouracil/administration & dosage , Infusions, Parenteral , Leucovorin/administration & dosage , Neoplasm Metastasis , Peritoneal Neoplasms/secondary , Jejunal Neoplasms/pathology , Intestinal Obstruction/etiology , Intestinal Obstruction/surgeryABSTRACT
A 33-year-old female presented with intermittent abdominal pain and severe attacks of lower gastrointestinal [GI] bleeding since 2 weeks. She has had history of irregular menses in last 3 months. In the labeled RBC-Scan study, the bleeding site was detected in left upper quadrant [LUQ]. In surgery, a tumor with the diameter of 2x1cm in a 65 cm distance of ligament of Trietz was detected. In pathological assessment jejunal metstatic choriocarcinoma was reported. Generally, choriocarcinoma is very rare among the intestinal metastatic tumors, including less than 5% of these tumors. Its presentation is acute lower GI bleeding and organ rupture, especially splenic rupture. These tumors will respond appropriately to the treatment in initial stages. Chemotherapy is the treatment of choice in these tumors
Subject(s)
Humans , Female , Choriocarcinoma/diagnosis , Choriocarcinoma/drug therapy , Choriocarcinoma/diagnostic imaging , /diagnosis , /drug therapy , /diagnostic imaging , Jejunal Neoplasms/complications , Jejunal Neoplasms/diagnosis , Jejunal Neoplasms/diagnostic imaging , Jejunal Neoplasms/drug therapy , Jejunal Neoplasms/etiology , Uterine Neoplasms , Pregnancy , JejunumABSTRACT
O propósito deste trabalho é fazer uma revisão detalhada da grande diversidade tumoral que acomete o segmento jejuno-ileal do tubo digestivo, buscando subsídios para um diagnóstico quanto possível precoce e um tratamento mais eficaz. Fazem parte deste estudo somente pacientes com localização tumoral primária no segmento jejuno-ileal do tubo digestivo (mestastáticos) e os com tumores duodenais e da junção íleo-cecal; excluíram-se também pacientes com quadros de hiperplasias, assim como os portadores de tumores de natureza puramente inflamatória.