A Case of the Primary Small Intestinal Carcinoma with its Metastasis to the Stomach Accompanied by the Primary Mucinous Carcinoma of the Colon

Masami Kawai, Yasutaka Matsuzaki, Shinsuke lyomasa, Ken Hiei, Hiroyuki Matsunaga, Yoshimasa Yamaguchi

Department of Surgery, Tsushima City Hospital

A 68-year-old man was admitted complaining of melena. We made a diagnosis of double cancer of the stomach and the small intestine by endoscopy and UGI, and performed an operation. A jejunal tumor, 15 cm in diameter, was extirpated. The 1st and the 2nd jejunal arteries were cut at their radix. We also found a mucinous carcinoma of the transverse colon at the hepatic flexure, and performed right hemicolectomy before distal partial gastrectomy. The patient is free from any sign of recurrence. Histological examination revealed that the jejunal tumor was a mucinous carcinoma without signet-ring cells, and that the colon cancer was also a mucinous carcinoma with signet-ring cells. The carcinoma of the stomach occupied the submucosal layer, and was distinguished clearly from the surroundings. Normal glandular cells remained in the middle part of the adenocarcinoma cells which resembled those of the jejunal lesion rather than those of the transverse colon. Because of the findings above, we made a diagnosis of metastatic jejunal carcinoma in the stomach accompanying the primary transverse carcinoma. Carcinoma of the small intestine is rare, and is known to have poor prognosis. No case of metastatic jejunal carcinoma in the stomach has ever been reported before.

Key words
primary small intestinal carcinoma, metastatic carcinoma to the stomach

Reprint requests
Masami Kawai Department of Surgery, Tsushima City Hospital
3-73 Tachibana-cho, Tsushima City, 496 JAPAN

Accepted
April 23, 1997

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