Abstract
A 76-year-old man was admitted with abdominal distension and pain. A barium study of the small intestine revealed a narowing portion of the small bowel about 20cm from the ileum end. He underwent a resection of the ileum together with the right hemi-colon. The histopathological diagnosis of the tumor was well-differentiated squamous cell carcinoma. A series of post-operative examinations including chest and abdominal CT, gastrointestinal endoscopy and otolaryngeal study did not reveal any other malignant lesion. Thirteen months later, a tumor was found in the soft tissue of the left upper arm. Histopathological examination of the resected tumor again showed squamous cell carcinoma, suggesting metastasis from the intestinal tumor.During the following period cervical lymph node metastasis and a recurrent tumor in the left upper arm appeared. The patient died of abdominal recurrence 28months after the intestinal operation. Since no primary lesion of the intestine was detected during a follow-up period of over 2years, a diagnosis of primary squamous cell carcinoma of the ileum was made. Primary squamous cell carcinoma of the small intestine has rarely been reported to be located in the duodenum. As far as we investigated, only one case in the ileum has been reported in the last 50years.
