Intussuscepted Metachronous small bowel tumor after treatment for colorectal adenocarcinoma

Abstract

Highlights We present a case of a small bowel adenocarcinoma at an advanced stage, following surgery and adjuvant therapy for colorectal adenocarcinoma, with an atypical presentation at the emergency room, as a rare cause of obstructive small bowel intussusception. After a successful removal of a carcinoma in the large bowel, there is a higher risk for developing a further primary (metachronous) large bowel tumor. However metachronous carcinomas affecting small bowel are rarer. Small Bowel adenocarcinoma (SBA) is a rare malignant neoplasm without specific signs and symptoms, and associated with late stage disease presentations. Patients who develop a small or large bowel adenocarcinoma are at high risk for a second cancer at both sites. However data available to guide therapeutic decisions for those presenting one at small bowel are scarce, and the role of adjuvant therapy in patients who undergo curative resection is unclear. Studies about strategies for detection at an earlier stage, optimal treatment and prognosis are mandatory for this disease.

Metachronous small bowel adenocarcinoma after rectal adenocarcinoma

“…[ 5 ] Patients with CRC have an increased risk of metachronous and primary colorectal tumors. [ 9 ] The risk of SBA is increased following primary CRC (30% for colon cancer and 40% for rectal cancer), and the risk of CRC is 4 to 5 times higher in patients diagnosed with primary SBA. [ 3 ] In the present case, the patient was finally diagnosed with metachronous SBA, and had undergone surgery and chemotherapy for rectal adenocarcinoma 30 months previously.…”

“…Crohn disease and celiac disease are the 2 most common diseases related to sporadic SBA, and both are associated with small intestinal inflammation [5] . Patients with CRC have an increased risk of metachronous and primary colorectal tumors [9] . The risk of SBA is increased following primary CRC (30% for colon cancer and 40% for rectal cancer), and the risk of CRC is 4 to 5 times higher in patients diagnosed with primary SBA [3] .…”

Case Report: Metachronous intussusception: A complex case report of small intestinal adenocarcinoma

“…Small intestinal adenocarcinomas, comprising less than 5% of digestive cancers, present a unique and increasingly recognized medical challenge. 1,2 Their rarity and association with predisposing pathologies contribute to delayed diagnoses, often at advanced stages. 1 Individuals undergoing treatment for colorectal cancer face a heightened likelihood of developing another primary malignant disease.…”

“…1,2 Their rarity and association with predisposing pathologies contribute to delayed diagnoses, often at advanced stages. 1 Individuals undergoing treatment for colorectal cancer face a heightened likelihood of developing another primary malignant disease. 1,3 Small bowel intussusception is a frequently encountered condition in childhood, primarily of unknown origin.…”

Spontaneous small bowel volvulus in young adult male

“…SBV is a rare occurrence of surgical emergency in western nations but is more common in Africa, India and Iran [3] . There are 2 main categories of volvulus: 1) Primary volvulus of the small bowel, without any identifiable anatomical causes [3] and 2) Secondary volvulus of the small bowel, where the torsion is caused by an abnormal underlying pathology such as adhesion bands [4] , tumors [5] , Meckel's diverticulum [6] and duplications [7] .…”