A Case of Primary Anaplastic Carcinoma of the Small Intestine

Masatoshi Kadoya¹⁾³⁾, Yasuhiro Suzuki¹⁾, Kazuaki Hazama¹⁾³⁾, Yoshitsugu Nakanishi¹⁾³⁾, Motoshi Kanai¹⁾³⁾, Motoo Takahashi¹⁾, Miri Fujita²⁾ and Hiroyuki Kato³⁾

¹⁾Department of Surgery, ²⁾Department of Pathology, Shinnittetsu Muroran General Hospital
³⁾Department of Surgical Oncology, Division of Cancer Medicine, Hokkaido University Graduate School of Medicine

A 57-year-old man admitted to hospital for malaise was shown by laboratory data to have anemia. A CT scan and MRI examination showed a small intestinal tumor with a thickened wall, and an intestinal fluoroscopy showed an aneurysmal-type tumor with a rough area on the intestinal wall. A selective angiography revealed a light, stained tumor with the ileal artery supplying nutrients. A malignant lymphoma of the intestine was thus suspected. An emergency operation was performed because of peritonitis. The rupture of the intestinal tumor, accompanied by multiple small tumors on the oral side, to the intra-abdomen caused peritonitis at a point located 90 cm on the anal side of the Treitz' ligament. The small intestine was resected extensively. Histologically, the tumor was identified as an anaplastic carcinoma with multiple intramural metastases; further immunohistochemical examination revealed the lesion to be positive for CAM 5.2 and Vimentin. The patient recovered and began to ingest solid food, but he died 55 days after the operation when his condition rapidly deteriorated. An autopsy revealed an intra-abdominal recurrence and distant metastases to the left lung, liver, and other locations. Anaplastic carcinoma of the small intestine is a rare disease; we describe the findings of the present case and review the relevant medical literature.

Key words
anaplastic carcinoma, small intestinal cancer, small intestinal tumor

Reprint requests
Masatoshi Kadoya Department of Surgical Oncology, Division of Cancer Medicine, Hokkaido University Graduate School of Medicine Kita-15, Nishi-7, Kita-ku, Sapporo, 060-8638 JAPAN

Accepted
June 25, 2003

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