title: A case of primary jejunal cancer diagnosed by preoperative small intestinal endoscopy.
abstract: The patient was a 37-year-old female. She was brought to our hospital by ambulance with nausea and vomiting. Abdominal ultra sound and abdominal enhanced CT scan showed a tumor in left side of the abdominal aorta 6 cm in size, and it showed an expanded stomach and duodenum. Upper gastrointestinal series revealed an apple core sign in upper jejunum near the Treitz' ligament. Small intestinal endoscopy (XSIF-240 endoscope, Olympus Inc.) revealed stenosis related to an epithelially protruding lesion with an irregular surface in the jejunum on the anal side of the horizontal duodenal peduncle. Biopsy suggested a well-differentiated adenocarcinoma. Scintigraphy showed hot spot in left middle abdomen. Under a diagnosis of primary jejunum cancer, Partial resection of the jejunum and partial resection of the transverse colon was performed. Histopathologically, the tumor was well differentiated adenocarcinoma exposed serosal surface. Postoperatively, the stage was evaluated as III (T3, N1, M0). Preoperative diagnosis to use small intestinal endoscopy was effectiveness. We report a patient with primary jejunum cancer in whom a definitive diagnosis was made before surgery.
authors.affiliation: Department of Surgery, Tokai University, School of Medicine, 143, Shimokasuya, Isehara Kanagawa 259-1193, Japan. nabesima@is.icc.u-tokai.ac.jp
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Nabeshima
authors.forename: Takao
authors.initials: T
authors.lastname: Machimura
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Wasada
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Takayasu
authors.forename: Kyoji
authors.initials: K
authors.lastname: Ogoshi
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Makuuchi
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D000328:Adult; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D007421:Intestine, Small / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D007580:Jejunal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D011300:Preoperative Care; D014055:Tomography, Emission-Computed; D016896:Treatment Outcome