title: Small bowel adenocarcinoma of the jejunum: a case report and literature review.
abstract: BACKGROUND
  In practice, small bowel cancer is a rare entity. The most common histologic subtype is adenocarcinoma. Adenocarcinoma of the small bowel (SBA) is challenging to diagnose, often presents at a late stage and has a poor prognosis. The treatment of early-stage SBA is surgical resection. No standard protocol has been established for unresectable or metastatic disease.
  
  
  METHODS
  We report here on a 26-year-old man with SBA in the jejunum, lacking specific symptoms and with a delay of 6 months in diagnosis. The diagnosis was finally achieved with a combination of balloon-assisted enteroscopy, computed tomography scans, positron emission computed tomography scans and the values of carcino-embryonic antigen and carbohydrate antigen 19-9. The patient underwent segmental intestine with lymph node resection, followed by eight cycles of FOLFOX palliative chemotherapy with good tolerance. As of the 11-month postoperative follow-up, there has been no evidence of recurrent disease.
  
  
  CONCLUSIONS
  This case is reported to arouse a clinical suspicion of SBA in patients with abdominal pain of unknown cause. We also provided evidence in this case of a response to palliative chemotherapy with FOLFOX. Because the incidence of SBA is very low, there is a need for further studies to evaluate the possible application of newer investigative agents and strategies to obtain a better outcome within the framework of international collaborations.
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital, Xi'an Jiaotong University Health Science Center, Xi'an, 710004, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital, Xi'an Jiaotong University Health Science Center, Xi'an, 710004, China.
authors.forename: Zhiliang
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Cell Biology and Genetics, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, China.
authors.forename: Na
authors.initials: N
authors.lastname: Liu
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital, Xi'an Jiaotong University Health Science Center, Xi'an, 710004, China.
authors.forename: Junfeng
authors.initials: J
authors.lastname: Hao
authors.affiliation: Department of General Surgery, The Second Affiliated Hospital, Xi'an Jiaotong University Health Science Center, Xi'an, 710004, China. xuxin72722@126.com.
authors.forename: Xin
authors.initials: X
authors.lastname: Xu
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D057210:Delayed Diagnosis; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D007580:Jejunal Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D007583:Jejunum / Q000601:surgery; D002955:Leucovorin / Q000627:therapeutic use; D008297:Male; D009944:Organoplatinum Compounds / Q000627:therapeutic use
chemical_list: D009944:Organoplatinum Compounds; D002955:Leucovorin; D005472:Fluorouracil
keywords: Diagnosis; FOLFOX; Rarity; Small bowel adenocarcinoma; Surgery