[A case report of primary adenocarcinoma of small intestine successfully treated with FOLFOX].
This is an account of a case of primary adenocarcinoma of the small intestine successfully treated with chemotherapy. A 46-year-old man was admitted with a complaint of severe abdominal distension. Abdominal computerized tomography revealed bowel obstruction, and this was found at surgery to be due to a tumor at the jejunum 100 cm distal from the Treitz ligament. Pathological diagnosis of the resected specimen was adenocarcinoma. Although adjuvant chemotherapy with doxifluridine 800 mg/day was given, a recurrent lesion at the abdominal wall was detected 19 months after surgery. Colonoscopy simultaneously revealed stenosis at the descending colon. The patient was subsequently treated with resection of the mass at the abdominal wall, and colostomy was made at the transverse colon to circumvent the stenosis due to peritoneal carcinomatosis. It was not long before another recurrence developed at the abdominal wall with a subsequent rise in tumor markers. mFOLFOX6 (oxaliplatin 85 mg/m2, levofolinate calcium 200 mg/m2, 5-FU 400/2,400 mg/m2) was given, and the patient responded. Primary small intestinal adenocarcinoma is a rare disease with a dismal prognosis. Due to rarity of the disease, clinical trials have not been performed, and little is known about the effect of chemotherapy. The current patient survived for 4 years and 5 months after the diagnosis, owing at least partially to the mFOLFOX6 which was found to be the only active regimen.
Sugae
Takashi
T
Dept. of Surgery, Aichi Prefectural Koseiren Kainan Hospital.
Yaguchi
Toyohisa
T
Kajikawa
Masaki
M
Nakayama
Shigeki
S
Takase
Tsunenobu
T
Inokawa
Yoshikuni
Y
Tsushima
Yukiko
Y
Watanabe
Toshiya
T
Harada
Akio
A
D000230:Adenocarcinoma / Q000097:blood / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002272:Carcinoembryonic Antigen / Q000097:blood; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D007414:Intestinal Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D007421:Intestine, Small / Q000187:drug effects* / Q000378:metabolism / Q000601:surgery; D002955:Leucovorin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure
D002272:Carcinoembryonic Antigen; D009944:Organoplatinum Compounds; D002955:Leucovorin; D005472:Fluorouracil