Adenocarcinoma of the ileum; a rare cause of intestinal obstruction

Abstract

Small bowel carcinomas are usually in advanced, terminal stages when they are diagnosed. It's clinical rarity and multiple possible clinical presentations, makes diagnosis and management challenging. In this case report, we discuss about an elderly female who presents with intestinal obstruction due to a tumor in the ileum, which later proved to be a moderately differentiated adenocarcinoma of the small intestine.

Jejunal adenocarcinoma in a young female patient – Case Report

“…Primary and secondary malignancies of the small intestine are very rare. Adenocarcinomas are the second-commonest type of tumour [1,2,3]. SBA is commoner in the duodenum, especially in the peri-ampullary region, than in the jejunum.…”

“…SBA shows a male preponderance with a male: female ratio of 1.4:1. It has been shown to increase in incidence after 40 years of age [3,4,5].…”

“…Animal studies have shown a relationship between SBA and exposure to bile and chemical carcinogens, possibly explaining the proximity of the majority of SBAs to the opening of the bile duct [3]. Rapid small intestinal transit, higher IgA production and a lower number of bacteria have been proposed as possible explanations for the lower incidence of SBA than colorectal adenocarcinoma [5].…”

“…A high intake of animal fat, red meat and alcohol and smoking are implicated as risk factors, though not proven conclusively. Coeliac disease, Crohn's disease and familial cancer syndromes like familial adenomatous polyposis, hereditary non-polyposis coli and Peutz-Jeghers syndrome are risk factors for SBA [3,4].…”

“…The duodenum and the small intestine comprise about 75% of the digestive tract but the incidence of neoplastic lesions is extremely low, especially compared to that of the large intestine which accounts for only a quarter of the length of the small bowel. A variety of tumours, both malignant and benign, are reported from the small intestine, accounting for 2-5% of the neoplasms in the gastrointestinal tract [1,2,3]. The commonest type of primary malignant neoplasm of the small intestine is carcinoid (35%-42%) followed by adenocarcinoma (30%-40%), lymphoma (15%-20%) and sarcoma (10%-15%) [4,5].…”