Risk of Duodenal Adenoma in Celiac Disease

Rampertab, S. Devi; Fleischauer, Aaron; Neugut, Alfred I.; Green, P H R

doi:10.1080/00365520310004515

Cited by 12 publications

(4 citation statements)

References 18 publications

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“…In a series of 94 cases of small bowel adenocarcinoma from the Mayo Clinic, evidence of flat dysplasia at the tumor margin was noted in 50% of cases associated with celiac disease [ 18 ]. Although some authors suggested that carcinomas in celiac disease may arise from adenomatous polyp [ 19 ], others found no increased incidence of duodenal adenomas in celiac disease [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Small Bowel Adenocarcinoma as the Cause of Gastrointestinal Bleeding in Celiac Disease: A Rare Malignancy in a Common Disease

Fallah

Afari

Córdova

et al. 2015

Case Reports in Oncological Medicine

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Introduction. Celiac disease is associated with an increased risk of small bowel malignancies, particularly lymphoma. Its association with small bowel carcinoma is less known. Case Description. We report a case of an 89-year-old woman with celiac disease who experienced recurrent episodes of gastrointestinal bleeding and was ultimately found to have adenocarcinoma of the small intestine. Discussion and Evaluation. Diagnosis of small bowel adenocarcinoma is often delayed because of the need for specialized modalities, which are often deferred in the inpatient setting. Although resection is the modality of choice for small bowel tumors, a majority is either locally advanced or metastatic at diagnosis, and even localized cancers have worse prognosis than stage-matched colorectal tumors. The role of adjuvant chemotherapy is uncertain, but it is often offered extrapolating data from other gastrointestinal cancers. Small bowel carcinomas occurring in the context of celiac disease appear to be associated with higher rates of microsatellite instability than sporadic tumors, although other specific genomic abnormalities and mechanisms of carcinogenesis in celiac disease remain unknown. Conclusion. Recurrent episodes of gastrointestinal bleeding in a patient with celiac disease should prompt an early evaluation of the small bowel to assure timely diagnosis of carcinoma at an early curable stage.

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Section: Discussionmentioning

confidence: 99%

Small Bowel Adenocarcinoma as the Cause of Gastrointestinal Bleeding in Celiac Disease: A Rare Malignancy in a Common Disease

Fallah

Afari

Córdova

et al. 2015

Case Reports in Oncological Medicine

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“…Another hypothesis which has been postulated is that small bowel adenocarcinoma in CD arises through an adenoma-carcinoma sequence [13]. However, currently there are conflicting results regarding this hypothesis [14,15,16,17]. …”

Section: Discussionmentioning

confidence: 99%

Small Bowel Adenocarcinoma in a Patient with Coeliac Disease: Case Report and Review of the Literature

Richir¹,

Songun²,

Wientjes

et al. 2010

Case Rep Gastroenterol

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Coeliac disease (CD) is an autoimmune disorder which leads to chronic inflammation of the gut. Furthermore, CD is associated with upper gastrointestinal malignancies, particularly lymphoma of the small intestine. Besides lymphoma, an increased frequency of associated small bowel carcinoma has been described. Here we report the case of a 70-year-old male suffering from CD who was treated with a gluten-free diet presenting with complaints of nausea, vomiting and weight loss of about 8 kg in two months. He underwent esophagogastroduodenoscopy, which identified distention of the stomach and duodenum and in the pars horizontalis a distinct obstruction was suggestive. However, histopathological examination showed a normal mucosal membrane. Additionally, a computed tomography scan of the abdomen was performed which showed an expanded stomach and duodenum up to the ligament of Treitz. During an explorative laparotomy a small tumor was palpated near the ligament of Treitz. Subsequently, a duodenal segment resection was performed. After surgery, the patient recovered well and left our hospital in good condition.

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“…Small bowel adenocarcinoma is normally rare, but may be more frequently recognized in celiac disease. Some have suggested that these may be due to an adenoma-carcinoma sequence,54 but others have reported that the risk of duodenal adenoma is not increased in celiac disease 81. Most occur in the proximal small intestine and may cause bleeding or obstruction.…”

Section: Other Cancersmentioning

confidence: 99%

Adult Celiac Disease and Its Malignant Complications

Freeman¹

2009

Gut Liver

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Adult celiac disease is a chronic intestinal disorder that has been estimated to affect up to 1-2% of the population in some nations. Awareness of the disease has increased, but still it remains markedly underdiagnosed. Celiac disease is a pathologically defined condition with several characteristic clinical scenarios that should lead the clinician to suspect its presence. Critical to diagnosis is a documented responsiveness to a gluten-free diet. After diagnosis and treatment, symptoms and biopsy-proven changes may recur and appear refractory to a gluten-free diet. Recurrent symptoms are most often due to poor diet compliance, a ubiquitous and unrecognized gluten source, an initially incorrect diagnosis, or an associated disease or complication of celiac disease. Some patients with persistent symptoms and biopsy-proven changes may not have celiac disease at all, instead suffering from a sprue-like intestinal disease, so-called unclassified sprue, which is a specific entity that does not appear to respond to a gluten-free diet. Some of these patients eventually prove to have an underlying malignant cause, particularly lymphoma. The risk of developing lymphoma and other malignancies is increased in celiac disease, especially if initially diagnosed in the elderly, or late in the clinical course of the disease. However, recent studies suggest that the risk of gastric and colon cancer is low. This has led to the hypothesis that untreated celiac disease may be protective, possibly due to impaired absorption and more rapid excretion of fat or fat-soluble agents, including hydrocarbons and other putative cocarcinogens, which are implicated in the pathogenesis of colorectal cancer.

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Risk of Duodenal Adenoma in Celiac Disease

Cited by 12 publications

References 18 publications

Small Bowel Adenocarcinoma as the Cause of Gastrointestinal Bleeding in Celiac Disease: A Rare Malignancy in a Common Disease

Small Bowel Adenocarcinoma as the Cause of Gastrointestinal Bleeding in Celiac Disease: A Rare Malignancy in a Common Disease

Small Bowel Adenocarcinoma in a Patient with Coeliac Disease: Case Report and Review of the Literature

Adult Celiac Disease and Its Malignant Complications

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