Enterovesical fistula caused by ileal primary adenocarcinoma

Journal of Coloproctology - Tập 38 - Trang 154-157 - 2018
Romualdo da Silva Corrêa1, Fellipe Alexandre Macena Salviano1, Luís Felipe Revorêdo Antunes de Melo1, José Manoel Dantas Junior2, Igor Rafael Guedes Pereira Brandão2, Thiago Barros Pinheiro2
1Universidade Federal do Rio Grande do Norte, Hospital Universitário Onofre Lopes, Natal, RN, Brazil
2Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil

Tóm tắt

Abstract Introduction Small bowel neoplasms are rare entities, with only 3.2% of gastrointestinal tumors localized in this segment. Adenocarcinoma is the second most common histologic type among small bowel neoplasms. The disease's symptoms are non-specific, with abdominal pain being the most common. Among the complications, fistulas are a far rare condition. Case report We present the case of an 86-year-old woman, hypertensive, diabetic, and former smoker, with lower abdominal pain, hematuria, fecaluria and fever associated with weight loss. Upon physical examination presented pale mucous membranes. Magnetic resonance imaging of the abdomen showed parietal thickening in the distal ileum segment with an anterior wall bladder fistula. Absence of metastases.Subjected to transurethral endoscopic biopsy of the bladder lesion, which anatomopathological study was compatible with invasive mucinous adenocarcinoma. An enterectomy was performed with primary enteroanastomosis, associated with partial cystectomy by videolaparoscopy. Anatomopathological study of the surgical specimens concluded mucinous adenocarcinoma with signet ring cells located in the small bowel and bladder. Immunohistochemical exam has identified findings compatible with mucinous adenocarcinoma of origin in the small bowel. The patient evolved well, being discharged, and returned to postoperative follow-up without signs of relapse of the disease. Conclusion The relative inaccessibility of the small bowel and the malignant neoplasms’ non-specific symptoms make an early diagnosis difficult. Discovery of the disease, often only at an advanced stage, results in complications and less effective therapy. The laparoscopic approach might be advantageous and effective in the treatment of advanced small bowel cancer with invasion of adjacent structures.

Tài liệu tham khảo

Siegel, 2017, Cancer Statistics, 2017, CA Cancer J Clin, 67, 7, 10.3322/caac.21387 Pourmand, 2016, Small bowel neoplasms and polyps, Curr Gastroenterol Rep, 18, 23, 10.1007/s11894-016-0497-x Bilimoria, 2009, Small bowel cancer in the United States changes in epidemiology treatment, and survival over the last 20 years, Ann Surg, 249, 63, 10.1097/SLA.0b013e31818e4641 Aparicio, 2014, Small bowel adenocarcinoma: epidemiology, risk factors, diagnosis and treatment, Dig Liver Dis, 46, 97, 10.1016/j.dld.2013.04.013 Bennett, 2015, Lifestyle factors and small intestine adenocarcinoma risk: a systematic review and meta-analysis, Cancer Epidemiol, 39, 265, 10.1016/j.canep.2015.02.001 Coco, 2010, Surgical treatment of small bowel neoplasms, Eur Rev Med Pharmacol Sci, 14, 327 Halfdanarson, 2010, A single institution experience with 491 cases of small bowel adenocarcinoma, Am J Surg, 199, 797, 10.1016/j.amjsurg.2009.05.037 Negoi, 2015, A maioria dos cânceres de intestino delgado são revelados por uma complicação, Einstein, 13, 500, 10.1590/S1679-45082015AO3380 Šutalo, 2016, Adenocarcinoma of the small intestine as the cause of an acute abdomen – two case reports with a review of the literature, Medicina Academica Mostariensia, 4, 69 Heathcote, 1980, Perforation of an adenocarcinoma of the small bowel affected by regional enteritis, Gut, 21, 1093, 10.1136/gut.21.12.1093 Raghav, 2013, Small bowel adenocarcinomas – existing evidence and evolving paradigms, Nat Rev Clin Oncol, 10, 534, 10.1038/nrclinonc.2013.132 Kudo, 2007, Carcinoma arising from ileorectal fistula in a patient with Crohn's disease, Nihon Shokakibyo Gakkai Zasshi, 104, 1492 Hamid, 1997, Adenocarcinoma of the ileum with an enterotubal fistula presenting as an adnexal mass, Gynecol Oncol, 64, 270, 10.1006/gyno.1996.4555 Ying, 1998, Primary adenocarcinoma in an enterocutaneous fistula associated with Crohn's disease, Can J Gastroenterol, 12, 265, 10.1155/1998/125235 Muraoka, 2008, A case report of the mucinous adenocarcinoma of the small intestine that has a vesicointestinal fistula, Jpn J Gastroenterol Surg, 41, 1631, 10.5833/jjgs.41.1631 Farrell, 2005, Mucusuria – an unusual manifestation of ileal adenocarcinoma: a case report and review of the literature, Int Surg, 90, 85 Zaaimi, 2015, Advanced small bowel adenocarcinoma: molecular characteristics and therapeutic perspectives, Clin Res Hepatol Gastroenterol, 40, 154, 10.1016/j.clinre.2015.09.008 Duerr, 2016, A retrospective review of chemotherapy for patients with small bowel adenocarcinoma in British Columbia, J Cancer, 7, 2290, 10.7150/jca.16606 Czaykowski, 2007, Chemotherapy in small bowel adenocarcinoma: 10-year experience of the British Columbia Cancer Agency, Clin Oncol, 19, 143, 10.1016/j.clon.2006.12.001
Thông tin
Thông tin xuất bản

Journal of Coloproctology

Tập 38

154-157

Thông tin tác giả