A CASE OF SMALL CELL CARCINOMA OF THE SMALL INTESTINE WITH PERITONITIS CARCINOMATOSA AND MULTIPLE HEPATIC METASTASES TO WHICH CDDP+CPT-11 REGIMEN WAS EFFECTIVE

Abstract

A 48-year-old woman complaining of left lower abdominal pain was admitted to the hospital with a diagnosis of intestinal obstruction. Abdominal CT scan showed an irregular shaped tumor in the pelvis. Barium enema study, however, showed only extrinsic pressure to the sigmoid colon. The patient was operated on with the diagnosis of an intra-abdominal tumor on September 6, 2005. At surgery we saw an about 7-cm sized tumor in the small intestine invading the left pelvic peritoneum, and then performed partial excision of the small intestine. Peritoneal dissemination was also seen in the right subdiaphrag-matic space. In 3 weeks after the operation the patient experienced rapidly aggravating pleural metastasis, pleural effusion, hepatic metastasis, and peritoneal dissemination. The pathological diagnosis was small cell carcinoma of small intestine. Then CDDP (60mg/m²)+CPT-11 (60mg/m²) regimen was started on October 4. When 2 courses of the regimen were completed, a reduction of the tumor and improvement of general condition were observed. However, the regimen had to be withdrawn after the completion of 4th course because she had influenza, when the tumor mass abruptly started to enlarge. The patient died on February 27, 2006.
Since a possibility that CDDP+CPT-11 regimen might contribute to life prolongation for patients with small cell carcinoma of small intestine is suggested, we report this case together with some bibliographical comments.