Papillary adenocarcinoma arising in a tubular duplication of the jejunum

Abstract

ABSTRACT. Alimentary tract duplications are uncommon congenital anomalies containing a normal gastrointestinal mucosa and smooth muscle layer. Intestinal duplication in the jejunum is rare, and any malignancy arising in the jejunal duplication is extremely rare. In this report, we present the first case of papillary adenocarcinoma arising in a tubular duplication of the jejunum. Coronal reformatted images from contrast-enhanced CT revealed a well-enhanced tubular mass in the distal jejunum with small bowel obstruction. There were multiple enlarged lymph nodes in the small bowel mesentery around the superior mesenteric artery. The typical macroscopic and histological findings were present.

Adenocarcinoma arising in a cystic duplication of the small bowel: case report and review of literature

“…If malignant change is found in small bowel duplications, the high rate of lymph node metastases should be considered [ 26 ]. The mode of metastasis is similar to that of primary small bowel cancer [ 26 , 27 ]. Curative resections could hardly be performed [ 26 , 28 ].…”

Adenocarcinoma of Jejunal Duplication Cyst—Case Report and Review of Literature

“…Small bowel DC can be associated with all the three segments—duodenum, jejunum, and ileum, of which almost 50% of the duplications arise from jejunum. Various theories proposed regarding the development of DC include (a) recanalization after the solid epithelial stage of embryonic bowel development; (b) intrauterine vascular accident theory; (c) persistent embryologic diverticula, but no single theory can explain all the known duplications [ 2 – 4 ]. The accepted diagnostic criteria for an enteric DC include three characteristics—a well-developed smooth muscle coat, epithelial lining representing some portion of the AT mucosa, and intimate anatomic association with some portion of the AT [ 5 ].…”

“…Carcinoma in jejunal duplication is extremely rare, and only three cases have been reported till date. The mode of growth and metastasis in these tumors is similar to that of primary small bowel cancer [ 4 ]. Preoperative diagnosis of tumors associated with DC is very difficult even after cross-sectional imaging with contrast-enhanced CT or MRI.…”

Adenocarcinoma Originating From a Completely Isolated Duplication Cyst of the Mesentery in an Adult

“…Malignant changes of in communicating type duplication cysts were most frequently observed in the small bowel, followed by the colon, rectum, and stomach. 17 , 18 Such changes can originate from the underlying mucosa and develop into adenocarcinoma in almost all cases. However, in our case, there was no remaining normal mucosa, only heterotrophic mucosa.…”