Adenocarcinoma of Aberrant Pancreas in the Jejunum: Report of a Case

Introduction

Aberrant pancreas in the jejunum is a rare condition, and its malignant transformation is very unusual.

Case report

We presented a case in which jejunal carcinoma occurred in the aberrant pancreas. A 76-year-old woman was admitted to our hospital due to repetitive vomiting after meals. Radiology showed high obstruction in the proximal jejunum. Laparotomy revealed that the obstruction was a submucosal tumor. Partial resection of the jejunum including the tumor was performed. Histology showed that the tumor was made up of well-differentiated adenocarcinoma originating from aberrant pancreatic tissues.

Conclusion

This was the tenth case of aberrant pancreatic carcinoma in the jejunum reported in literature.     

甲状旁腺腺癌1例报道

1临床资料 患者男性，44岁。因四肢关节反复疼痛、活动受限4年伴症状加重2周于2004年12月第1次入住我院。在外院多次行四肢关节X线检查示有骨质疏松，血钙4．0mmol／L，门诊甲状腺B超示右侧甲状腺实性包块。颈部及胸部CT提示：①右侧甲状旁腺腺瘤；②继发性右锁骨、右第6肋、左第3肋骨囊性纤维性骨炎；     

Primary Duodenal Adenocarcinoma without Stenosis: A Case Report with a Brief Literature Review

This article focuses on the symptomatic and diagnostic problems of primary duodenal adenocarcinoma (PDA) by way of two case reports and a literature review. An 85-year-old woman with an adenocarcinoma in the 1st duodenal portion was offered palliative care. A 90-year-old woman with an adenocarcinoma in the 3rd duodenal portion was also offered palliative care. A unique finding in the two cases reported herein is that PDA did not cause stenosis and occlusion of the lumen. As no reports of PDA without stenosis have been published so far, these cases may add to our knowledge of PDA. The diagnosis of PDA is often delayed because its symptoms may be absent until the tumor has progressed, thus leading to a delay of several months. Patients typically present with a long history of variable and vague symptoms, and many are diagnosed with advanced disease. As regards clinical manifestations, abdominal pain is the most frequent symptom. The majority of these tumors are found to have infiltrated the duodenal wall at presentation, with many being unresectable due to local and distal invasion. Esophagogastroduodenoscopy and gastrointestinal barium radiography are the main diagnostic tests for PDA, detecting 88.6 and 83.3% of tumors, respectively. In some cases, ultrasonography or computed tomography are useful for detecting PDA and determining vascular invasion.Key words: Primary duodenal adenocarcinoma, without stenosis; Primary duodenal adenocarcinoma, first portion; Primary duodenal adenocarcinoma, third portion; Best supportive care; Symptoms; Clinical manifestations     

孤立性肺结节—周围型腺癌1例

1临床资料患者,男性,68岁,因＂间断胸痛、胸闷3个月＂入院。患者3个月前静息时突发胸痛及胸闷,于外院查心电图示Ⅱ、Ⅲ、aVF、V8、V9导ST段抬高,13h后复查ECG相应导联出现病理性Q波。     

Primary Adenocarcinoma Arising in the Jejunal Limb of a Roux-en-Y Esophago-jejunostomy: A Case Report

Adenocarcinoma of the small bowel is uncommon. Due to the paucityand lack of specificity of symptoms, patients are usually seenlate in the course of their illness when curative therapy, mainlyrepresented by wide surgical resection, is unlikely. The authorsreport a case of primary adenocarcinoma arising in the jejunallimb transposed for a Roux-en-Y esophagojejunostomy reconstructioneight years after a total gastrectomy performed for an advancedgastric cancer (pT₂N₁M₀), with mixed histological pattern (tubular-mucinous)and negative CEA staining of cancer cells. Evidence for excludingthe possibility of a recurrence of the primitive gastric cancerwas based on the different histologic pattern, positive CEAstaining of cancer cells and other features of the second neoplasm.Early diagnosis of the neoplasm was made possible by its favorableanatomic location and the early onset of symptoms, which promptedeffective surgical therapy (wide resection). The authors, furthermore,analyze and discuss the possible pathogenesis of the neoplasm,based on the evidence of slow jejunal limb emptying, elevatedconcentration of N-Nitroso compounds and contamination by N-nitrosatingbacteria in the jejunal limb juice, suggesting that each ofthese factors could have had a role to play in the developmentof the jejunal malignancy.     

Mucinous Adenocarcinoma of the Thymus: A Case Report

A mucinous adenocarcinoma of the thymus is rare, and there is presently limited information on the clinical aspects of this uncommon type of tumor. Only six cases have been reported in the literature. A 49-year-old Japanese male presented with an anterior mediastinal mass, and underwent a tumor resection. Histologically the tumor consisted of a mucinous adenocarcinoma with pleural dissemination. Postoperative radiotherapy and chemotherapy were performed. The patient is still alive with pleural dissemination 11 months after surgery.     

Double Adenocarcinoma in Barrett's Esophagus: A Case Report

At the National Cancer Center Hospital in Tokyo, a patient withBarrett's esophagus developed double adenocarcinoma of the esophagus.One carcinoma was located in the midesophagus and the otherjust above the anatomic cardia. Esophagoscopic examination withbiopsy revealed two carcinomas surrounded with columnar epitheliumand ectopic islets of gastric mucosa situated in the postcricoidregion. There was no ulcer or stricture in the esophagus. Thepatient received subtotal esophagectomy and survived the operation.Microscopically, depth of invasion of the proximal cancer wasto the proper muscle, and that of the distal one was to thesubmucosal layer. There was metastasis to two lymph nodes. Therewas no sign of inflammation or ulcer in the esophagus.     

肺腺癌心脏转移1例报道

肺癌是心脏恶性转移瘤中最常见的原发肿瘤，临床上心脏作为肿瘤的靶器官容易被忽略。我科最近收治1例肺腺癌心脏转移患者，报道如下。 1临床资料     

EGFR-Mutated Breast Metastasis of Lung Adenocarcinoma: A Case Report

Breast metastasis from other primary carcinoma is very rare and could be difficult to identify despite immunohistochemistry analysis. Breast metastasis from lung adenocarcinoma can mimic triple-negative breast cancer. Given the prognosis and therapeutic challenges, a correct diagnosis appears essential, and molecular biomarkers could be useful. We report the case of a 52-year-old woman with a breast mass initially diagnosed as primary breast cancer and secondarily attached to breast metastasis from an EGFR-mutated lung adenocarcinoma. The same activating EGFR mutations were identified in both the primary lung carcinoma and the breast metastasis.Key Words: Lung adenocarcinoma, Breast metastasis, EGFR mutation, Triple-negative breast cancer, EGFR tyrosine kinase inhibitors     

Metachronous Colon Metastases from Gastric Adenocarcinoma: A Case Report

The colon is a very rare metastatic localization. Here we report a case of colonic metastases from gastric adenocarcinoma whose clinical presentation was suggestive of a de novo adenocarcinoma of the ascending colon. The authors discuss that in the presence of a previous history of gastric cancer, immunohistochemical analysis on endoscopic biopsies may help in the definition of a differential diagnosis. Furthermore, this rare metastatic localization might suggest a poor prognosis and a more accurate diagnostic work-up.Key Words: Gastric adenocarcinoma, Colonic metastases, CDX-2     

Primary Pulmonary Hemangiopericytoma: A Case Report

Primary pulmonary hemangiopericytoma is a very rare tumor. Acase of the disease is reported, together with a review of theliterature. The patient was a 78-year-old male, who was admittedto hospital with an abnormal shadow on his chest x-ray. A primarytumor, located in the left S⁴, was resected, and a final diagnosisof hemangiopericytoma of pulmonary origin was made. The diseaserecurred in the left lower lobe 14 months postoperatively. Thepatient received radiotherapy and is alive to date, 23 monthsafter the operation.     

Synchronous Primary Adenocarcinoma and Ancient Schwannoma in the Colon: An Unusual Case Report

Gastrointestinal schwannomas are uncommon stromal tumors of the intestinal tract and colon schwannomas are extremely rare. We report a rare case of ascending colon schwannoma with associated synchronous adenocarcinoma of the sigmoid colon. A 68-year-old man presented with a 20-day history of bleeding per rectum. Colonoscopy revealed a mass of 4.2 cm in diameter with endoluminal protrusion in the sigmoid colon and a second submucosal tumor in the ascending colon. Surgical intervention was suggested and ileo-hemicolectomy was done. Microscopically, the submucosal tumor of 4 cm in diameter showed features of schwannoma with degenerative change (ancient schwannoma). Lesional cells were positive for S100p and negative for actin, desmin, CD34, CD117, and pankeratin. The mass showed features of an invasive moderately differentiated adenocarcinoma. Colon schwannoma is a rare submucosal tumor, and the incidental occurrence with adenocarcinoma has not been well described in the literature.Key words: Schwannoma, Ancient schwannoma, Gastrointestinal tract, Adenocarcinoma     

Calcifications in Mutinous Adenocarcinoma of the Stomach: A Case Report

Thirty-nine cases of calcification of the gastric carcinomahave been reported in world medical literature. Calcificationsare always punctate in appearance, permitting a confident diagnosisof mucinous adenocarcinoma. An additional case of a sixty-nine-year-oldfemale with calcification in musinous adenocarcinoma, is presentedhere with emphasis on the usefulness of computed tomography.     

肺腺癌所致乳糜胸1例

1临床资料患者女性,78岁,退休医生,主因"间断喘息3个月,加重半月"于2011年1月31日入院。患者于入院前3个月无明显诱因出现活动后喘息,无发热、咳嗽、咳痰,无胸痛和心悸,查心电图示"窦性心动过速",予"倍他乐克"口服,喘息无明显缓解;半月前喘息加重,伴轻咳少痰,查电解质、心肌酶、血常规、脑钠肽等均正常,"倍     

Metastatic Prostatic Adenocarcinoma Mimicking Inflammatory Breast Carcinoma: A Case Report

Prostate adenocarcinoma can manifest as a fairly indolent tumor or as a very aggressive cancer with significant invasive and metastatic potential. Common metastatic sites include bone, liver, lymph nodes, and adrenal glands. Dermatologic manifestations are rare. We present a case of a man who presented with breast skin changes that mimicked inflammatory breast carcinoma with specialized testing ultimately giving a diagnosis of metastatic prostatic adenocarcinoma. A 78-year-old man presented with left breast redness and swelling. Examination revealed an erythematous rash with subcutaneous edema over the left hemithoracic area. A breast ultrasound showed no focal mass, and a breast core biopsy had no evidence of tumor. A skin biopsy showed metastatic carcinoma in dermal lymphatics, and the tumor was found to have no estrogen or progesterone receptors or HER2 expression. Computed tomography scans, positron emission tomography, and a nuclear bone scan revealed widespread skeletal metastases. The patient received a 3-month course of capecitabine and cyclophosphamide with no improvement in his skin lesions. Subsequent immunohistochemical staining on the tumor specimen was positive for prostate-specific antigen (PSA) and α-methyl-CoA-racemase, confirming a diagnosis of metastatic prostatic adenocarcinoma. He received leuprolide and bicalutamide and demonstrated significant improvement with near-complete resolution of his skin lesions and a decrease in his PSA level. Prostatic adenocarcinoma presenting initially as a breast malignancy is a rarely recognizable clinical event. Undoubtedly, increased awareness and recognition of the rare entity described herein will allow for the prompt initiation of specific therapies, which might be of benefit to many patients.     

直肠腺癌伴肛周Paget病1例

患者男性,68岁。因反复便血十余天,伴乏力、四肢酸软而入院。患者无发热,无腹痛、腹部包块,无恶心呕吐。体检:肛门及肛管触及乳头状隆起肿块,表面结节状,指套染血。污血涂片细胞学检查找到高度可疑癌细胞。结肠造影示直肠近肛门处可见黏膜部分中断,呈双边改变,并见充盈缺损影,管腔略变窄。肝胆B超见左肝内囊肿,胆囊结石,后腹膜及盆腔未见明显异常团块回声。实验室检查血常规,中性粒细胞升高,血AFP、CEA、CA199、CA125正常范围。病理检查结果:送检直肠癌Miles术标本,直肠长29cm,直肠近齿状线处见隆起型肿块,大小3.5cm×3.5cm×1cm,菜花…     

Laryngeal Metastasis from a Pulmonary Papillary Adenocarcinoma: A Case Report

Metastases to the larynx from distant primaries are very rare.The present article reports a case of metastatic papillary adenocarcinomaof the larynx of lung origin. The patient was a 59-yearold femalenon-smoker, who had a history of adenocarcinoma of the rightlung. For the laryngeal tumor, we performed a partial laryngectomyfollowing biopsy. The tumor of the larynx was a papillary adenocarcinomaresembling the lung tumor, both demonstrating positive immunohistochemical staining for pulmonary surfactant apoprotein.The findings emphatically indicated the laryngeal tumor to bemetastasis from the primary papillary adenocarcinoma of thelung. The present case report presents the clinical findings,course of disease and histopathological findings with briefreviews of the literature.     

原发性腹膜后恶性间质瘤1例报告

1资料 患者女性,72岁,主诉因上腹胀2周入院,无腰痛、血尿,无其它不适主诉.入院查体:血压(14.7～18.7)/(10.0～12.0)kPa(110～140)/(75～90)mmHg,一般情况好,皮肤巩膜无黄染,全身浅表淋巴结未及肿大,腹部平软,左上腹局限性轻度压痛,腹部未及肿块,腹水征阴性.双下肢无浮肿.入院检查:B超提示左侧肾上腺区域探及8.6cm×7.8cm低回声团块,血供丰富.KUB IVP检查左肾上腺区可见软组织块影,左肾受压,左肾上肾盏变平.