Abstract
A 64-year-old man was admitted to our hospital because of close examination of anemia which was pointed out on health screening. He underwent Billroth II distal gastric resection for a duodenal ulcer 37 years before. An abdominal computed tomographic scanning showed a low density mass with a cavity on the jejunum extending from the rest stomach, and the margin of the mass was enhanced. An upper GI tract X-ray study revealed a sharply circumscribed massive lesion having irregular ulcer on the jejunal anastomosis. Endoscopically, a deep ulcer was found at the jejunal anastomosis, and histology of the biopsy specimen taken from there revealed mucinous adenocarcinoma. The jejunum including remnant stomach was partially resected, and the specimen showed ulcerative and well demarcated carcinoma, measuring 12.3×7.7×7cm in diameter. The carcinoma disclosed marked extraluminal growth without serosal spreading. Histological examination revealed mucinous adenocarcinoma of the jejunum lacking lymphatic and venous invasion, and the lymph nodes were free from the carcinoma. Seven reports of mucinous adenocarcinoma of the small intestine have been described in the Japanese and the English literatures. All of them are rather large in size, and measured up to 15cm in diameter. Only 1 case of them has lymph node metastasis. Judging from above clinicopath-ological features, mucinous adenocarcinomas of the small intestine seemed to be well demarcat-ed and to have low incidence of lymph node metastasis. Thus that tumor appeared to have good prognosis.
