Coexistence of Adenocarcinoma of the Jejunum and Nontropical Sprue

Abstract

CommentThe reported case is unusual, first, because a desmoid tumor was found in the abdominal wall inside of the costal arch. Gatchell, Clagett, and McDonald8 recently reported a case in which a desmoid tumor arose from the intercostal muscles of the right upper thorax. The second unusual feature is that the desmoid tumor involved the adherent colon. Considering the patient's history of prolonged abdominal distress following an automobile accident 10 years prior to the present admission, it seems plausible that she had had some injury to the abdominal wall and the bowel tract at that time which led to adhesions between the colon and the abdominal wall, and that subsequently the desmoid which originated in the traumatized area of the abdominal wall extended into the densely adherent portion of the transverse colon. Summary A patient had a desmoid tumor of the abdominal wall inside the costal arch, which involved the distal portion of the transverse colon close to the splenic flexure. The lesion was found accidentally when the patient was operated on for a duodenal ulcer. Subtotal gastrectomy and segmental colon resection, with excision of the abdominal wall inside the costal arch, performed in one stage, led to complete cure of the patient.

Diagnosis and management of adult coeliac disease: guidelines from the British Society of Gastroenterology

“…Finally, numerous studies have confirmed the association between CD and B-cell lymphoma284 – 286 and CD and small intestinal adenocarcinoma 42 254 287 – 289…”

Nature of the mucosal changes associated with malignant neoplasms in the small intestine.

“…Girdwood et al (1961) described the coexistence of subtotal villous atrophy in a jejunal biopsy, malabsorption, and an anaplastic carcinoma 70 cm. below the duodeno-jejunal junction; and Moertel and Hargraves (1961) have also reported a case in which jejunal adenocarcinoma complicated long-standing malabsorption, and was associated with villous atrophy of the jejunal mucosa. It may well be that case 18 in my series represents a fifth example of jejunal adenocarcinoma complicating idiopathic steatorrhoea in a clinicallyasymptomatic phase;the mucosal abnormalities in this case certainly form a striking contrast to the relatively normal mucosa observed in the other cases of small-bowel carcinoma.…”

Carcinoma, villous atrophy, and steatorrhoea.

“…One of these was a woman of 56 years who developed an adenocarcinoma of the stomach. The other report was by Moertel and Hargraves (1961) who describe a man of 68 years who had non-tropical sprue for 11 years and developed an adenocarcinoma of the jejunum. Ogilvie and Shaw (1955), in an article on 'primary tumours of the small bowel', included a man of 40 years, who had had 'steatorrhoea for years' and developed an adenocarcinoma of the duodenojejunal junction.…”