Concurrent Occurrence of Tumor in Colon and Small Bowel following Intestinal Obstruction: A Case Report and Review of the Literature

Abstract

An intestinal obstruction occurs when either the small or large intestine is partly or completely blocked so it prevents passing the food or fluid through the small/large bowel. This blockage is due to the existence of a mechanical obstruction such as foreign material, mass, hernia, or volvulus. Common symptoms include cramping pain, nausea and vomiting, changes in bowel habits, inability to pass stool, and lack of gas. We present a case of an 83-year-old man who had been referred to Taleghani Hospital with symptoms of bowel obstruction. He underwent the surgery. The findings of exploration of the entire abdomen showed two types of mass separately in two different organs. In postoperative workup, pathology reported two types of tumors (adenocarcinoma and neuroendocrine tumors).

A rare case of metachronous neuroendocrine tumor after a colorectal adenocarcinoma: qualitative critical review of synchronous and metachronous gastrointestinal NET

“…To date, the literature in English reveals, 20 case reports (18 synchronous cases [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24], 2 metachronous cases [25,26]), 2 case series [25,27], 3 review articles [28][29][30], and about 10 retrospective studies [31][32][33][34] or population-based studies from a National Registry [35][36][37][38][39][40][41] of synchronous or metachronous NET with a second primary malignancy (SPM). A total of 31 patients in 24 articles were included in the study: 28 patients with a synchronous gastrointestinal NET and colorectal adenocarcinoma (Table 1) and 3 patients (including the present study) of 3 articles with metachronous gastrointestinal NET and colorectal adenocarcinoma ( Table 2).…”

“…Pearson and Fitzgerald were the first to report the high incidence (23%) of second primary malignancies (SPM) in patients with small intestinal NETs at autopsy [27]. A certain number of NETs were incidentally found during surgery for other [7] 1972 53 M Rectum Rectum -Lotlikar et al [25] 1981 53 M Rectum Small bowel -Lotlikar et al [25] 1981 67 F Right colon Small bowel -Lotlikar et al [25] 1981 60 F Sigmoid colon Small bowel -Sacchi et al [8] 1988 57 M Right colon Small bowel -Tse et al [9] 1997 72 M Hepatic flexure Small bowel -Habal et al [28] 2000 52 M Sigmoid colon Rectum Cioffi et al [10] 2005 64 F Ileum Small bowel -Klucinski et al [11] 2006 72 F Transverse colon Small bowel -Chemli et al [12] 2007 63 F Right colon Small bowel -Aslam et al [13] 2009 67 F Sigmoid colon Small bowel G1 Boland et al [14] 2009 77 F Left colon Meckel's diverticulum -McHugh et al [15] 2009 74 F Rectum Small bowel -Wohadlo et al [29] 2011 53 M Splenic-hepatic flexure Small bowel -Gurzu et al [16] 2012 78 F Sigmoid colon Small bowel G3 Pozzato et al [17] 2012 61 M Right colon Duodenum G1 Katalinic 2014 et al [18] 2014 63 M Right colon Meckel's diverticulum G1 Zhu et al [19] 2015 64 F Rectum Rectum G1 Almajano et al [20] 2016 66 M Right colon Small bowel G1 Mohapatra et al [21] 2016 83 M Sigmoid colon Left colon G3 Nejatollahi et al [22] 2016 83 M Sigmoid colon Small bowel G1 Vootla et al [23] 2016 46 F Hepatic flexure Rectum G1 Winn et al [30] 2017 40 M Sigmoid colon Rectum G1 Winn et al [30] 2017 70 M Sigmoid colon Rectum G1 Napolitano et al [24] 2017 72 M Right colon Small bowel G1-G2 cancers. The estimated rate of SPM associated with other malignancies was 2.3% in surgical cases and 8.1% in autopsy cases [42].…”

Multiple Small Intestinal Neuroendocrine Tumors With Findings of Intestinal Obstruction

“…Therefore, it is crucial to inspect the whole length of the small bowel intraoperatively [ 4 ]. About 70% of SI-NETs are found in the ileum, making it the most common site [ 6 ]. Although the small intestine makes up 75% of the length of the GI tract and 90% of the absorptive mucosal surface area, tumors of the small intestine are rarer than other GI malignancies [ 1 ].…”

Perforation of the cecum resulting from a closed-loop obstruction in a patient with an adenocarcinoma of the sigmoid colon: a case report

“…In addition, constipation or stool and flatus retention may also occur. In cases of mechanical obstruction, the possibility of malignancy must be taken into consideration; therefore attention should be paid to associated wasting symptoms such as weight loss, anorexia and weakness [3] , [4] .…”