title: Abdominal wall infiltration by small bowel adenocarcinoma in a patient with Crohn's disease--a case report.
abstract: A 46-year-old man with Crohn's disease was referred to our hospital. In 2007, abdominal pain accompanied by redness and swelling of the right lower quadrant developed. A small bowel series and computed tomography of the abdomen revealed a stricture in the terminal ileum, suggesting a penetration of the abdominal wall. He was transferred to the department of surgery, and the affected portion of the bowel was resected to eliminate the stricture. At laparotomy, the ileum 35 cm proximal to the ileocecal valve adhered to the abdominal wall in the right lower quadrant. The involved site of the ileal wall and a portion of the abdominal wall were resected. Postoperative microscopic examination revealed an invasion of the abdominal wall by an ileal adenocarcinoma; reoperation was therefore performed. Histopathological examination revealed an adenocarcinoma at the previously sutured site of the ileal wall, against a backdrop of Crohn's disease. The postoperative recovery was good, and the patient received chemotherapy. During follow-up, computed tomography and positron emission tomography demonstrated abnormal changes of the abdominal wall, suggesting a recurrence. He received radiotherapy of the abdominal wall. Although he had tentative regression, the patient died 1 year and 9 months after the first operation.
authors.affiliation: Dept. of Surgery, Toho University Sakura Medical Center.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Nihon-Yanagi
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Ooshiro
authors.forename: Akihiro
authors.initials: A
authors.lastname: Yamada
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Noriaki
authors.initials: N
authors.lastname: Kameda
authors.forename: Shinichi
authors.initials: S
authors.lastname: Okazumi
mesh_terms: D034861:Abdominal Wall / Q000473:pathology*; D000230:Adenocarcinoma / Q000150:complications / Q000473:pathology / Q000601:surgery*; D002430:Cecal Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D003424:Crohn Disease / Q000150:complications / Q000601:surgery*; D017809:Fatal Outcome; D006801:Humans; D007078:Ileal Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012008:Recurrence; D014057:Tomography, X-Ray Computed