Abstract
A 73-year-old woman was seen at our hospital because of abidominal distension and vomiting. An upper gastorointestinal endoscopy and colonofiberscopy revealed no abnormal findings. Intestinal fluoroscopy showed a tumor with stricture in the small intestine. Thereafter, the patient developed an intestinal obstruction and was admitted to our hospital. After admission, a partial excision of the amall intestine was performed. The intestinal tumor had produced a narrowing of the entire circumference of the small intestine at a point 100cm on the anal side of the Treitz'ligament. Three intramural metastases were also observed. Histologically, the tumor was identified as an undifferentiated carcinoma infiltrating the subserosal layer. Further immunohistochemical examination disclosed the differentiation of neuroendocrine cells and the overexpression of p53. Three months after the operation, the patient was readmitted to the hospital because of another intestinal obstruction. The recurrence of the small bowel cancer was confirmed, and a gastorojejunostomy and a gastrostomy were perfomed. The patient died from the rapid progress of cancer 6 months after the onset of the symptoms. An extremely rare case of an undifferentiated cancer with neuroendocrine differentiation of the small intestine is pressented here.
