A Case of Effective Multisciplinary Treatment for Carcinoma of the Ileum with Multiple Organ Metastases

Naomasa Yoshida, Yasuhiro Sumi, Katsutoshi Murase, Tsuyoshi Shimamoto, Tetsuya Kondoh, Ryusei Matsuyama, Takuya Sugimoto and Yutaka Ozeki

Department of Surgery, Shizuoka Medical Center

A 64-year-old man admitted for abdominal pain had ileus symptoms due to intestinal obstruction and was found in colonoscopy to have an upheaval tumor with rand wall in the terminal ileum. Histological biopsy of the tumor showed adenocarcinoma. Abdominal CT showed a round 80×60 mm tumor with a clear border in the right hepatic lobe together with several swollen lymph nodes around the aorta, which we diagnosed as primary cancer of the ileum and liver and lymph nodes metastasis, necessitating ileocecal resection and right hepatic lobectomy. Pathologically, the tumor consisted of moderately differentiated adenocarinoma invading the serosa. The solitary hepatic tumor consisted of metastatic adenocarcinoma. Lymph nodes around the aorta were reduced after chemotherapy. Subsequent bilateral lung metastasis disappeared after another cycle of chemotherapy, as did spine metastasis after radiation. The man is doing well two years and six months after surgery. Carcinoma of the small intestine usually has a poor prognosis. Multisciplinary treatment with surgery may improve prognosis, so we recommend proactive treatment.

Key words
carcinoma of the ileum, liver metastasis, multisciplinary treatment

Reprint requests
Naomasa Yoshida First Department of Surgery, Gifu University, School of Medicine
1-1 Yanagido, Gifu, 501-1194 JAPAN

Accepted
October 19, 2004

To read the PDF file you will need Abobe Reader installed on your computer.