Double primary adenocarcinomas of the jejunum and descending colon with lung metastases presenting rare immunohistochemical phenotypes: a case report.
We report a male patient with double advanced tumors in the jejunum and descending colon and multiple lung tumors. The intestinal cancers were surgically resected. Immunoprofiling of the specimens revealed a rare phenotype: the jejunal cancer was positive for cytokeratin (CK) 7, partially positive for CK20, and Cdx-2-negative, whereas the colon cancer was CK7(+), CK20(-), and Cdx-2(-). Biopsied lung tumor was diagnosed as tubular adenocarcinoma, and CK7(+)/CK20(+)/Cdx-2(-). Together with clinical information, we deduced that the jejunal adenocarcinoma had presumably metastasized to the lung. Moreover, postoperative oxaliplatin, including chemotherapy, significantly reduced the lung metastases, suggesting that this regimen is a promising treatment option for advanced small bowel adenocarcinoma.
Nozawa
Hiroaki
H
Department of Surgery, Odaira Memorial Tokyo Hitachi Hospital, Yushima, Bunkyo-ku, Tokyo 113-0034, Japan. hiroanozawa-gi@umin.ac.jp
Yamada
Yoshinao
Y
Muto
Yasuhiko
Y
Endo
Junji
J
Asakage
Masahiro
M
Oka
Teruaki
T
Furukawa
Yoichi
Y
Arai
Masami
M
D000230:Adenocarcinoma / Q000737:chemistry / Q000235:genetics / Q000556:secondary* / Q000628:therapy; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000032:analysis*; D001706:Biopsy; D000071616:CDX2 Transcription Factor; D017024:Chemotherapy, Adjuvant; D003082:Colectomy; D003110:Colonic Neoplasms / Q000737:chemistry / Q000235:genetics / Q000473:pathology* / Q000628:therapy; D017809:Fatal Outcome; D005472:Fluorouracil / Q000627:therapeutic use; D018398:Homeodomain Proteins / Q000032:analysis; D006801:Humans; D007150:Immunohistochemistry; D007580:Jejunal Neoplasms / Q000737:chemistry / Q000235:genetics / Q000473:pathology* / Q000628:therapy; D053554:Keratin-20 / Q000032:analysis; D053552:Keratin-7 / Q000032:analysis; D002955:Leucovorin / Q000627:therapeutic use; D008175:Lung Neoplasms / Q000737:chemistry / Q000235:genetics / Q000556:secondary* / Q000628:therapy; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000627:therapeutic use; D000077150:Oxaliplatin; D010641:Phenotype; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D000071616:CDX2 Transcription Factor; C491270:CDX2 protein, human; D018398:Homeodomain Proteins; C507499:KRT20 protein, human; C507497:KRT7 protein, human; D053554:Keratin-20; D053552:Keratin-7; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D002955:Leucovorin; D005472:Fluorouracil