Adenocarcinoma with adenoma in the jejunum suggesting an adenoma-carcinoma sequence in the small bowel: A case report

Nakano, Yujiro; Adachi, Yasushi; Okamoto, Hideki; Kiyama, Y.; Koyama, Takashi; Nakamura, Shinichi; Li, Qing; Sakaida, Noriko; Uemura, Yoshiko; Ikehara, Susumu

doi:10.3892/ol.2014.2210

Cited by 3 publications

(2 citation statements)

References 9 publications

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“…By comparing markers of proliferation among normal mucosa, adenomatous polyps, and invasive adenocarcinoma, many have postulated that the adenomato-carcinoma sequence applies to SBA. 26,27 Research studies that examine molecular pathways in SBA do not necessarily separate tumor samples from patients with sporadic mutations from those with germ-line mutations because it is believed that patients with genetic syndromes are simply one step further along the adenoma-to-carcinoma sequence. In fact, much of what we know stems from molecular and clinical analysis of samples from patients with germ-line mutations, such as FAP and Lynch's syndrome.…”

Section: Genetics and Molecular Biologymentioning

confidence: 99%

Small Bowel Adenocarcinoma

Chen

Vaccaro

2018

Clinics in Colon and Rectal Surgery

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Small bowel adenocarcinoma is a clinically and anatomically distinct gastrointestinal cancer that lacks prospective data to support its optimal management. Patients with inflammatory bowel disease and inherited conditions that cause gastrointestinal polyps are at especially high risk. Due to a lack of effective surveillance programs resulting in missed or delayed diagnoses only when symptoms develop, this disease is generally discovered at an advanced stage. Surgical resection is the only treatment modality with a chance of cure. Currently accepted treatment considerations are often generalized from large bowel and pancreatic-biliary cancers, due to some anatomic and clinical parallels. Additional research, however, is desperately needed to characterize the unique molecular differences of this disease to better prognosticate patients and establish rational clinical trials that would improve their outcomes.

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Section: Genetics and Molecular Biologymentioning

confidence: 99%

Small Bowel Adenocarcinoma

Chen

Vaccaro

2018

Clinics in Colon and Rectal Surgery

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“…In particular, in duodenal adenocarcinomas with duodenal adenomas, it is extremely difficult to diagnose duodenal carcinomas owing to FAP in patients without a family history of FAP. Previous reports have suggested the presence of the adenoma-carcinoma sequence in small intestine carcinomas [ 14 ]. However, there are also reports that the adenoma-carcinoma sequence in small intestine carcinomas is extremely rare [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Next-Generation Sequencing for Non-Ampullary Duodenal Carcinoma Suggesting the Existence of an Adenoma-Carcinoma Sequence

Yoshida

Kojima

Shimada

et al. 2021

Case Rep Gastroenterol

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Duodenal tumors with a sporadic adenoma-carcinoma sequence are extremely rare. For such clinically suspected cases without a specific family history, performing a comprehensive gene search is important to understand the germline mutation background. We present a 68-year-old woman without a genetic or familial history of familial adenomatous polyposis (FAP), Peutz-Jeghers syndrome, or Lynch syndrome who presented to Kosei Hospital, Japan, with exertional dyspnea induced by abdominal pain lasting 3 weeks. A duodenal tumor was suspected by contrast-enhanced computed tomography. Esophagogastroduodenoscopy showed a lesion accompanied by a white microprotuberance on the descending part of the duodenum opposite the papilla, with a giant ulcerative lesion at the center of the white lesion. Biopsy revealed a low-grade adenoma, high-grade adenoma, and adenocarcinoma. Immunohistochemical analysis of the adenoma and adenocarcinoma showed Ki-67, p53, cytokeratin 20, caudal-type homeobox 2, and carcinoembryonic antigen positivity and cytokeratin 7 negativity. The findings suggested the presence of an adenoma-adenocarcinoma sequence in duodenal carcinoma. However, in the mutational analysis using next-generation sequencing, c.4348C>T (p.Arg1450Ter) mutation in APC was detected in all normal mucosal, adenoma, and carcinoma tissues. This mutation is common in FAP patients. Even if the presence of an adenoma-adenocarcinoma sequence in duodenal carcinoma is suggested in cases without a familial FAP history, as in this case, genetic analysis may reveal FAP. Thus, performing a comprehensive genetic analysis of duodenal carcinoma patients with a possible adenoma-carcinoma sequence is necessary to explore their genetic background.

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Duodenal adenocarcinoma: Advances in diagnosis and surgical management

Cloyd¹,

George²,

Visser³

2016

WJGS

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Duodenal adenocarcinoma is a rare but aggressive malignancy. Given its rarity, previous studies have traditionally combined duodenal adenocarcinoma (DA) with either other periampullary cancers or small bowel adenocarcinomas, limiting the available data to guide treatment decisions. Nevertheless, management primarily involves complete surgical resection when technically feasible. Surgery may require pancreaticoduodenectomy or segmental duodenal resection; either are acceptable options as long as negative margins are achievable and an adequate lymphadenectomy can be performed. Adjuvant chemotherapy and radiation are important components of multi-modality treatment for patients at high risk of recurrence. Further research would benefit from multi-institutional trials that do not combine DA with other periampullary or small bowel malignancies. The purpose of this article is to perform a comprehensive review of DA with special focus on the surgical management and principles.

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Adenocarcinoma with adenoma in the jejunum suggesting an adenoma-carcinoma sequence in the small bowel: A case report

Cited by 3 publications

References 9 publications

Small Bowel Adenocarcinoma

Small Bowel Adenocarcinoma

Next-Generation Sequencing for Non-Ampullary Duodenal Carcinoma Suggesting the Existence of an Adenoma-Carcinoma Sequence

Duodenal adenocarcinoma: Advances in diagnosis and surgical management

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