A CASE OF PRIMARY ILEAR UNDIFFERENTIATED CARCINOMA

Abstract

This paper presents a case of primary ileal undifferentiated carcinoma as well as a clinicopathological study of 95 cases of primary small intestinal carcinoma in Japan from 1965 to 1990. A 63-year-lld man was admitted to the hospital. Laparotomy was carried out under a diagnosis of ileus. A hard tumor was found at the ileum 150cm oral side from the Bauhin. The tumor was polypoid type with the size of 4×3cm. Histological type of the tumor was undifferentiated carcinoma (P0, H0, ss, ly2, v0 n (-), M (-), ). Curative operation was performed. Of 95 cases of primary small intestinal carcinoma, 59 lesions in the jejunum and 33 in the ileum were diagnosed histologically. Sixty-four tumors (69.6%) were found within 49cm from the Treiz and Bauhin. In these parts of the small intestin, well and moderately differentiated adenocarcinomas were dominant (87-88%). And the rate of poorly differentiated adenocarcinomas and undifferentiated carcinomas was only 12 to 13%. On the other hand, the rate of poorly differentiated adenocarcinomas and undifferentiated carcinomas increased to 35.7% in the jejunum and ileum which were over 50cm far from the Treiz and Bauhin. In 13 cases showing preoperative serum CEA level of over 5ng/ml, 9 (69.2%) were non-curatively resected. Five of the 9 cases had peritoneal dissemination, 3 liver metastasis, 2 para-aortic lymph node metastasis, and 2 severe local invasion. So it was suggested that preoperative serum CEA level would be a good marker reflecting the stage of small intestinal carcinomas.