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Xiao L, Sun L, Zhang JX, Pan YS. Rare squamous cell carcinoma of the jejunum causing perforated peritonitis: A case report. World J Gastrointest Oncol 2022; 14:2295-2301. [PMID: 36438705 PMCID: PMC9694277 DOI: 10.4251/wjgo.v14.i11.2295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 09/25/2022] [Accepted: 10/18/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Adenocarcinoma has the highest incidence among malignant tumors of the small intestine (SI). Squamous cell carcinoma (SCC) often occurs in organs covered with squamous epithelium. Primary or metastatic SCC originating from the SI is very rare, with very few cases reported in the literature.
CASE SUMMARY This case report involves a 69-year-old man who developed abdominal pain after lunch. After admission, an abdominal computed tomography scan revealed perforation of the alimentary canal and multiple abnormal low-density lesions in the liver. During laparotomy, an approximately 4 cm × 3 cm-sized solid tumor was found in the jejunum, located 30 cm from the Treitz ligament, with a perforation. An intestinal segment of approximately 15 cm was removed, including the perforated portion. The pathological result was SCC. In combination with liver imaging, a diagnosis of SI SCC with multiple liver metastases was considered. The patient died from hepatic failure 1 mo after the operation.
CONCLUSION SI tumors are very rare compared to those originating in other digestive organs. Due to its insidious onset, the diagnosis of this disease is usually delayed. Clinicians must pay close attention to digestive symptoms such as persistent abdominal pain and melena.
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Affiliation(s)
- Lin Xiao
- Department of General Surgery, Peking University First Hospital, Beijing 100034, China
| | - Lie Sun
- Department of General Surgery, Peking University First Hospital, Beijing 100034, China
| | - Ji-Xin Zhang
- Department of Pathology, Peking University First Hospital, Beijing 100034, China
| | - Yi-Sheng Pan
- Department of General Surgery, Peking University First Hospital, Beijing 100034, China
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Yu X, Wang Z, Zhang Z, Liu Y, Huang J. Postoperation of cervical cancer with intestine metastasis: a case report and literature review. World J Surg Oncol 2016; 14:2. [PMID: 26739660 PMCID: PMC4704422 DOI: 10.1186/s12957-015-0759-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 12/30/2015] [Indexed: 01/13/2023] Open
Abstract
Background Cervical cancer can infiltrate locally and directly spread to adjacent organs including the vagina, peritoneum, urinary bladder, ureters, rectum, and paracervical tissue, but the intestine metastasis from cervical cancer is extremely rare, which can easily be misdiagnosed. Case presentation Here, we report a case about a 45-year-old postoperative cervical cancer patient with metastases to small intestine and sigmoid colon who presented abdominal distention and dull pain due to intestinal obstruction. The patient underwent exploratory laparotomy, and two intestinal segments including the tumors were resected. The postoperative pathological diagnosis illustrated sigmoid colon and terminal ileum metastatic squamous cell carcinoma. Conclusions This case demonstrates that intestine metastasis must be considered in the differential diagnosis of acute abdomen in patients with cervical cancer even at an early tumor stage.
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Affiliation(s)
- Xiuyan Yu
- Cancer Institute (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang Province, 310009, China.,Department of Surgical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang Province, 310009, China
| | - Zhen Wang
- Cancer Institute (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang Province, 310009, China.,Department of Surgical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang Province, 310009, China
| | - Zhigang Zhang
- Department of Gynecology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang Province, 310009, China
| | - Yang Liu
- Department of Gynecology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang Province, 310009, China
| | - Jian Huang
- Cancer Institute (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences, Zhejiang Province, China), The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang Province, 310009, China. .,Department of Surgical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang Province, 310009, China.
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A review of duodenal metastases from squamous cell carcinoma of the cervix presenting as an upper gastrointestinal bleed. World J Surg Oncol 2011; 9:113. [PMID: 21958048 PMCID: PMC3206441 DOI: 10.1186/1477-7819-9-113] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Accepted: 09/29/2011] [Indexed: 01/13/2023] Open
Abstract
Upper gastrointestinal bleeding due to duodenal metastases is extremely uncommon. Extra-pelvic spread of squamous cell carcinoma (SCC) of the cervix to the small bowel is rare with only 6 reported cases in the English literature since 1981(PubMed, Medline).We report the case of a 49-year-old woman who presented with upper-gastrointestinal bleeding two years after the diagnosis of SCC of the cervix. At esophagogastroduodenoscopy, there was a stricture in the second part of the duodenum which was biopsied for a suspected neoplastic lesion. Histologic and immunohistochemical examination showed a malignant lesion with characteristics identical to her original tumor in the cervix confirming the duodenal metastases.The clinical presentation of a 'malignant' upper-gastrointestinal bleed due to duodenal metastases from SCC of the cervix is unusual. Awareness of such infrequent patterns of metastases in cervical cancer confirmed by histopathological diagnosis is important for best practice therapeutic decisions in these patients.
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Misonou J, Natori T, Aizawa M, Jou B, Tamaki A, Ogasawara M. Stage (Ia) cervical cancer recurring 13 years after hysterectomy and causing small intestinal perforation. A case report with a review of the literature. ACTA PATHOLOGICA JAPONICA 1988; 38:225-34. [PMID: 3291552 DOI: 10.1111/j.1440-1827.1988.tb01100.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
A rare case of recurrent cervical cancer presenting multiple metastases to the small intestine is reported. A 69-year-old Japanese woman with a past history of early-stage (Ia) cervical cancer 13 years previously suffered sudden onset of panperitonitis caused by perforation of the small intestine. In the perforated lesion, squamous cell carcinoma, which was histologically similar to that of the primary lesion, was observed, and was diagnosed as a late recurrence of the cervical cancer. Perforation of the small intestine caused by tumor metastasis, especially metastasis from cervical cancer, rerely occurs. Furthermore, recurrence of an early cervical cancer presenting 13 years after hysterectomy is extremely rare. The present case draws attention to the possibility of late recurrence of cervical cancer, even in cases treated at the early-stage.
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Affiliation(s)
- J Misonou
- 1st Department of Pathology, Hokkaido University School of Medicine, Japan
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