title: [A Case of Long-Term Survival in a Patient with Small Intestinal Adenocarcinoma with Peritoneal Dissemination].
abstract: Primary small intestinal adenocarcinoma is rare and its outcome is poor. A 46-year-old man admitted for vomiting was found in enhanced abdominal CT to have local jejunum stenosis and dilation at its oral site. A partial jejunectomy was performed and a jejunal tumor with multiple disseminated nodules in the peritoneum was revealed. Histologically, the adenocarcinoma of the jejunum appeared to be a papillary adenocarcinoma, and also, in part, a moderately differentiated tubular adenocarcinoma. After the jejunectomy, the patient was treated with S-1 chemotherapy, but 22 months after the initial diagnosis, a recurrence was detected. The patient underwent a second partial jejunectomy, and a weekly dose of paclitaxel (PTX) plus doxifluridine (5'-DFUR) was selected as the second-line treatment. The patient is still responding to the treatment 55 months after the last operation. Combination chemotherapy with weekly PTX/5'-DFUR may improve the prognosis for S-1-resistant small intestinal adenocarcinoma.
authors.affiliation: Dept. of Surgery, Onomichi General Hospital.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Takemoto
authors.forename: Toshio
authors.initials: T
authors.lastname: Noriyuki
authors.forename: Daisuke
authors.initials: D
authors.lastname: Takei
authors.forename: Masumi
authors.initials: M
authors.lastname: Kawashima
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Saito
authors.forename: Natsumi
authors.initials: N
authors.lastname: Ono
authors.forename: Tatsunari
authors.initials: T
authors.lastname: Sasada
authors.forename: Makoto
authors.initials: M
authors.lastname: Yoshida
authors.forename: Minoru
authors.initials: M
authors.lastname: Yamaki
authors.forename: Hironobu
authors.initials: H
authors.lastname: Amano
authors.forename: Toshikatsu
authors.initials: T
authors.lastname: Fukuda
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nakahara
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000556:secondary / Q000601:surgery; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D005467:Floxuridine / Q000008:administration & dosage; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000601:surgery; D007580:Jejunal Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000556:secondary; D013997:Time Factors
chemical_list: D005467:Floxuridine; D017239:Paclitaxel; C025034:doxifluridine