Small bowel adenocarcinoma metastatic to the ovaries in a 12-year-old girl.
OBJECTIVE
Small bowel adenocarcinoma is a rare cancer and usually occurs in elderly males. A 12-year-old girl with metastatic small bowel adenocarcinoma and her clinical course are described. The difficulties in making the pathologic diagnosis and the literature are also reviewed.


METHODS
A 12-year-old girl had partial small bowel obstruction and bilateral ovarian enlargement. Exploratory laparotomy revealed a jejunal tumor with bilateral ovarian involvement and extensive peritoneal and pelvic studding. The pathologic diagnosis of small bowel adenocarcinoma was made.


RESULTS
The patient had a moderate response to therapy with 5-fluorouracil, leucovorin, and alpha-interferon before developing progressive disease unresponsive to therapy with topotecan, taxol, or carboplatin. She survived for 23 months after diagnosis.


CONCLUSIONS
Making an accurate diagnosis of tumors metastatic to the ovary can be difficult and requires attention to histologic detail. Small bowel adenocarcinoma is usually a chemoresistant tumor with extremely poor outcome. This patient had a moderate response to chemotherapy and a prolonged survival compared to that of patients previously reported.
Dunsmore
K P
KP
Department of Pediatrics, University of Virginia Health Sciences Center, Charlottesville 22908, USA.
Lovell
M A
MA
D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002648:Child; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D007414:Intestinal Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology; D007421:Intestine, Small / Q000473:pathology; D002955:Leucovorin / Q000627:therapeutic use; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000503:physiopathology / Q000556:secondary
D016898:Interferon-alpha; D002955:Leucovorin; D005472:Fluorouracil