A Case of Primary Adenosquamous Cell Carcinoma of the Jejunum

Hisayasu Aoki, Seiji Miura, Kanji Mieno, Hiroaki Wada, Keijirou Nozawa, Susumu Kodaira, Fumihiko Tanaka*

First Department of Surgery and Department of Clinical Pathology*, Teikyo University School of Medicine

A 64-year-old woman visited a medical clinic complaining of general fatigue, and was referred to our hospital because of an abdominal mass and anemia. Her serum CEA and CA19-9 levels were 21.7 ng/ml and 155.9 U/ml, respectively. An upper GI series revealed stenosis of the jejunum approximately 8 cm distal to Treitz's ligament, and a barium enema study showed a stenotic portion in the transverse colon. Under the tentative diagnosis of a jejunal tumor laparotomy was performed, and partial resection of the jejunum with lymph node dissection combined with right hemicolectomy was carried out. Macroscopically, the jejunal tumor had a small ulceration, forming an exrtaluminal mass about 8 cm in diameter, and involved the transverse colon. Histological examination revealed areas of adenocarcinoma forming moderately differentiated tumor glands, and areas of squamous cell carcinoma with mild keratinization showing sheet-like tumor growth. The patient died 32 months postoperatively, bearing liver metastases found in the 22nd postoperative month. Adeno-squamous cell carcinoma of the small bowel is very rare, and the present case appears to be the second reported from Japan.

Key words
adenosquamous cell carcinoma, small intestine, adenoacanthoma

Reprint requests
Hisayasu Aoki First Department of Surgery, Teikyo University School of Medicine
2-11-1, Kaga, Itabashi-ku, Tokyo, 173 JAPAN

Accepted
July 10, 1996

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