title: Multicentric primary adenocarcinomas of the midgut: the first case report.
abstract: Multicentric adenocarcinomas of the midgut have not been described; even multiple adenocarcinomas limited to the small intestine are extremely uncommon, with only 14 cases reported in the literature. We report a case of multicentric synchronous involvement of the entire midgut with adenocarcinoma in a 52-yr-old Polish woman who had more than 30 lesions extending from duodenum to mid-transverse colon. There was no family history of cancer. Preoperative evaluation and intraoperative exploration were negative for primary malignancy of the lungs, breasts, ovaries, pancreas, and other parts of the gastrointestinal tract. Results of histopathological examination, immunohistochemical staining, and ras mutational analysis of the lesions uniformly support the diagnosis of multicentric poorly differentiated adenocarcinoma. The cause for this unusual presentation is unknown, although sporadic genetic alteration(s) of oncogene(s) might have been the precipitating event.
authors.affiliation: Cook County Hospital, Rush Medical College, Chicago 60612, Illinois.
authors.forename: K J
authors.initials: KJ
authors.lastname: Liu
authors.forename: V
authors.initials: V
authors.lastname: Nadimpalli
authors.forename: M J
authors.initials: MJ
authors.lastname: Atten
authors.forename: H R
authors.initials: HR
authors.lastname: Chang
authors.forename: S D
authors.initials: SD
authors.lastname: Finkelstein
authors.forename: K
authors.initials: K
authors.lastname: Mak
authors.forename: B M
authors.initials: BM
authors.lastname: Attar
authors.forename: P E
authors.initials: PE
authors.lastname: Donahue
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology / Q000601:surgery; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D005260:Female; D011905:Genes, ras; D006801:Humans; D007150:Immunohistochemistry; D007414:Intestinal Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology / Q000601:surgery; D007421:Intestine, Small / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology / Q000601:surgery; D017354:Point Mutation
chemical_list: D014408:Biomarkers, Tumor