Small bowel adenocarcinoma in a patient with Coeliac disease: A case report

Mauro Lombardo,Gian Marco Giorgetti

doi:10.1186/1757-1626-1-159

Abstract

Coeliac disease is a chronic inflammatory disease of the gut with increased risk of gastrointestinal malignancy. Although enteropathy T-lymphoma is the most common neoplasm in patient affected by coeliac disease, an increased frequency of small bowel carcinoma has been described. We present a case of jejunal carcinoma in a patient suffering for coeliac disease in which gastrointestinal and extraintestinal symptoms of disease developed although he was treated with a gluten-free diet.

Highlights

Celiac disease is a chronic inflammatory disease of the gut occurring in genetically susceptible individuals in all age groups after ingestion of gluten
It affects approximately 1% of Caucasian populations [1], though it is significantly underdiagnosed. It is characterized by a flattened mucosa, villous atrophy and crypt hyperplasia in the small intestine and by the classic malabsorption syndrome or by minor apparently unrelated symptoms such as iron-deficiency anemia, osteopenic bone disease, amenorrhea and infertility [2]
We report a case of jejunal carcinoma in a patient suffering for coeliac disease in which gastrointestinal and extraintestinal symptoms of disease developed he was treated with a gluten-free diet

Summary

Introduction

Celiac disease is a chronic inflammatory disease of the gut occurring in genetically susceptible individuals in all age groups after ingestion of gluten. The patient had been diagnosed in 1990 with coeliac disease by an esophagogastroduodenoscopy (EGD) and duodenal biopsies He had been treated with a gluten-free diet and had some clinical improvements as disappearance of diarrhoea but continued to lose weight and had an increase of episodes of postprandial vomits. Histological evaluation of small bowel mucosa showed normal villi (Figure 3) with regular size of the crypts and absence of any inflammatory infiltrate in the lamina propria (Marsh 0 according to Marsh classification). He began a parenteral nutrition for recovering weight and a better resolution of disease

Discussion

Marsh MN

Findings

Conclusion