Abstract
Undifferentiated cancer of the small intestine has rarely been reported. We report herein a case of undifferentiated cancer of the small intestine with multiple metastases to the intestinal wall and lymph nodes around the pancreas head and a review of the literature.
A 53-year-old man was seen at our hospital because of body weight loss, thirsty and abdominal pain. On laboratory data, a marked inflammatory response (WBC 19,400/μl, CRP 14.8 ng/ml) and anemia (Hb 8.4 g/dl) were noted. Serum IL-2 receptor concentration increased to 2,400 IU/l, though tumor marker levels of CEA and CA19-9 were within normal limits. An abdominal CT scan showed the presence of multiple tumors with the size of less than 4 cm within the abdominal cavity. From these findings, malignant lymphoma in the abdominal cavity was initially diagnosed. This patient was surgically operated on in March 2008 due to the development of abdominal symptoms. Operative findings showed that tumors with the maximum diameter of 8 cm were scattered in the small intestinal wall, mesentery and pancreas head. Only the small intestine was resected, because his general condition was so unstable that the resection of the pancreas head might entail a high risk. The pathological diagnosis of undifferentiated cancer of the small intestine was made because only epithelial markers were positive. After the operation, however, his condition took a sudden turn for the worse, and he died on the 27th postoperative day.
