A case of superior mesenteric artery syndrome caused by TPF chemotherapy for primary adenoid cystic carcinoma of the buccal region

Abstract

Superior mesenteric artery syndrome (SMAS) is a rare cause of upper intestinal obstruction resulting from compression of the horizontal portion of duodenum by the superior mesenteric artery and abdominal aorta. A 54-year-old woman presented with frequent vomiting and sudden abdominal distension while receiving TPF (docetaxel + cisplatin + 5 - fluorouracil) chemotherapy for primary adenoid cystic carcinoma of the buccal region. Abdominal computed tomography (CT) showed distension of the stomach due to compression of the horizontal portion of the duodenum and a narrow angle between the superior mesenteric artery and abdominal aorta. We diagnosed SMAS based on the CT scan findings. The remarkable weight loss occurring during chemotherapy seemed to have caused SMAS. The patient soon improved in response to conservative therapy, such as insertion of a gastric tube and fluid replacement. This case illustrates the importance of considering SMAS in patients who receive chemotherapy, especially those presenting with weight loss.