2024 Volume 74 Issue 4 Pages 299-304
A 61-year-old woman came to our hospital with a chief complaint of orbital pain. She was admitted to our hospital with a diagnosis of small intestinal obstruction based on a simple contrast-enhanced computed tomography(CT) scan that showed mass-like wall thickening of the small intestine and dilatation of the intestinal wall at the mouth. Subsequently, small intestine endoscopy was performed, which revealed a whole circumferential elevated lesion in the jejunum. Biopsy results showed adenocarcinoma, and the diagnosis of small intestinal cancer was made. No metastasis was evident, and a partial resection of the small intestine was performed by laparotomy. Surgical findings showed that the tumor was located 50 cm from the Treitz ligament on the anorectal side. The tumor was resected at a distance of at least 5 cm from the tumor on the oral and anal sides, and the mesentery was dissected in a fan shape with the root of the SMA (superior mesenteric artery) branch of the J1a (first jejunal artery) at the apex. The patient had no postoperative problems. Cancer of the small intestine is extremely rare, and standard surgical technique has not been established to define the extent of bowel resection and lymph node dissection. According to previous reports, the most common lymph node dissection is that of the middle lymph node. One year after surgery without adjuvant chemotherapy, the patient is doing well with no signs of recurrence.
Primary small bowel cancer is a rare cancer, and standard treatment has not been established. We report a case of primary small bowel cancer with a review of the literature regarding the extent of dissection and treatment.
