A YOUNG ADULT CASE OF PRIMARY CARCINOMA OF THE JEJUNUM

Abstract

Primary adenocarcinoma of the jejunum is extremely rare, despite the fact that the small intestine is much longer than the colon. In addition the anatomy of the small intestine makes us difficult to diagnose the disease preoperatively. A 31-year-old male was admitted to our hospital because of intermittent epigastric pain lasting for 6 months. Gastric endoscopy and the abdominal ultrasonography revealed no abnormalities. Selective contrast radiography indicated primary carcinoma of the small intestine. Partial jejunectomy and resection of Schnitzler's metastasis were carried out. The tumor was located as a whole circumference stricture at the jujunum about 100cm anal side from the Treitz's ligament. Its histrogical diagnosis was well differentiated adenocarcinoma of Borrmann type 2. There was peritoneal dissemination in the Douglas Cul-de-sac, but no regional lymph node metastasis was observed. Resection of the intestine by about 120cm with peritoneal dissemination was performed, and then a reservoir was indwelt in the abdominal cavity. The patient received adjuvant chemotherapy with 100mg/body of CBDCA intraper-itoneally, 3000mg/body of 5-Fu intravenousily and 600mg/body/day of UFT orally. He is doing well without any signs of recurrence as of 2 years after the operation.