A Case of Adenocarcinoma Arising in Multiple Duplication of the Alimentary Tract

Minoru Kihara, Tetsuya Higashijima, Masato Koseki, Yasuji Obayashi, Kenji Nakamura and Akiko Nishitani

Second Department of Surgery, Kagawa Medical University

A case of adenocarcinoma arising in multiple duplication of the alimentary tract is reported. A 74-year-old woman complained of a sudden onset of abdominal pain in the right lower abdomen suddenly. Diagnostic images suggested a tumor in the same location. Laparotomy revealed a lesion growing like an extramural tumor, the size of 11×4 cm in the ileocecum. Rapid intraoperative frozen section diagnosis was adenocarcinoma. The lesion was thought to be metastatic carcinoma. Resection of the ileocecum and ascending colon was performed. Macroscopically and histopathologically, the lesion consisted of the alimentary tract had two duplicated tracts. Histopathological findings also showed that adenocarcinoma was arising in one of the duplication. It is very difficult to diagnose duplication of the alimentary tract preoperatively because of its uncharacteristic patterns in symptoms and examinations. Cases described of this disease have been increasing, but cases with multiple or malignant changes are very rare. There has been no case of neoplastic change in multiple duplication of the alimentary tract in literature to the best of our knowledge. This case is the first reported.

Key words
multiple duplication of the alimentary tract, malignant change, tubular duplications of the ileocecum

Reprint requests
Minoru Kihara Second Department of Surgery, Kagawa Medical University 1750-1 Miki-cho, Kita-gun, Kagawa, 761-0793 JAPAN

Accepted
February 24, 1999

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