Adenocarcinoma of the ileum: A rare and challenging entity

Abstract

IntroductionPrimary small bowel malignancy is unusual and accounts for 1–3% of all gastrointestinal tract neoplasms. Adenocarcinoma is one of the most common histologic types, but its frequency decreases with more distal locations. Its clinical presentation is nonspecific and is usually associated with advanced disease, which contributes to delayed diagnosis.Presentation of caseA 66-year-old woman was admitted to the hospital with a 6-day history of progressively worsening abdominal pain localized in the right lower quadrant, nausea, and vomiting. Investigation revealed an inflammatory appendiceal tumor. The patient underwent surgery and an unexpected tumor involving the distal ileal segment and ileocecal appendix was found. Right radical hemicolectomy with en bloc resection of the distal ileum was performed. Histopathological examination revealed adenocarcinoma of the ileum.DiscussionThis 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 locoregional lymphadenectomy. The role of adjuvant chemotherapy has yet to be determined.ConclusionThis case demonstrates an unusual condition characterized by late and challenging diagnosis. We highlight the importance of an earlier diagnosis and optimal treatment for improved patient outcomes.

Adenocarcinoma de la válvula ileocecal enmascarado por infección por actinomyces. Reporte de caso

“…Las neoplasias malignas primarias del intestino delgado son raras y representan del 1 al 3% de todas las neoplasias del tracto gastrointestinal. La incidencia anual estimada es de 2.1 casos por cada 100,000 personas, siendo el tipo histológico más frecuente el carcinoide (44%), seguido del adenocarcinoma (33%) 1 .…”

“…La válvula ileocecal es un sitio muy raro para los cánceres gastrointestinales 2 y al carecer de especificidad su presentación clínica cursa con una demora promedio de 6 a 10 meses para el diagnóstico 1 . En este artículo presentamos un caso de adenocarcinoma de la válvula ileocecal, metastásico, diagnosticado posterior a laparotomía exploradora y resección intestinal, patología enmascarada por un diagnóstico de actinomicosis en muestra tomada por colonoscopia.…”

Adenocarcinoma ileum: a rare cause of ileal stricture mimicking intestinal tuberculosis: a case report and literature review

“…The incidence of small bowel carcinoma worldwide is very rare, with an annual incidence of only 2.2 cases per 100,000 persons and is increasing. 4,5 Of them carcinoid tumor is more common than adenocarcinoma. Adenocarcinoma of ileum is least common amongst all small bowel malignancies.…”

“…Of them Crohns disease and celiac disease are the most important known risk factors, but other associations may coexist. 4,5,8 Adenocarcinoma of ileum can present as stenosing type with features of obstruction, or bleeding type. Stenosis related symptoms are rarely manifested in early disease as small intestinal products are liquid, and less likely to obstruct.…”

It's Not Always What it Says on the Tin: A Rare Case of Adenocarcinoma of the Ileocaecal Valve

“…Adenocarcinoma of the ileocaecal valve is rare and commonly appears as non-specific ICV thickening radiologically [1,2]. Right sided colonic lesions including of the ICV should be considered as a cause of melaena when OGD is normal.…”