A rare case of brain metastasis from poorly differentiated small bowel adenocarcinoma

  • Erika Yamazawa
    Departments of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tsukiji, Chuo-ku, Japan.
  • Yoshitaka Honma
    Departments of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tsukiji, Chuo-ku, Japan.
  • Kaishi Satomi
    Departments of Diagnostic Pathology, National Cancer Center Hospital, Tsukiji, Chuo-ku, Japan.
  • Hirokazu Taniguchi
    Departments of Diagnostic Pathology, National Cancer Center Hospital, Tsukiji, Chuo-ku, Japan.
  • Masamichi Takahashi
    Departments of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tsukiji, Chuo-ku, Japan.
  • Akihiko Yoshida
    Departments of Diagnostic Pathology, National Cancer Center Hospital, Tsukiji, Chuo-ku, Japan.
  • Koji Tominaga
    Department of Surgery, Denenchofu Central Hospital, Denentyoufu, Ota-ku, Tokyo, Japan.
  • Yasuji Miyakita
    Departments of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tsukiji, Chuo-ku, Japan.
  • Makoto Ohno
    Departments of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tsukiji, Chuo-ku, Japan.
  • Taku Asanome
    Departments of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tsukiji, Chuo-ku, Japan.
  • Natsuko Satomi
    Departments of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tsukiji, Chuo-ku, Japan.
  • Yoshitaka Narita
    Departments of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tsukiji, Chuo-ku, Japan.

Description

<jats:sec id="st1"> <jats:title>Background:</jats:title> <jats:p>Small bowel adenocarcinoma (SBA) accounts for <2% of all gastrointestinal malignancies. The most common organs of SBA metastases are the abdominal lymph node, liver, and peritoneum. There have been almost no reports of brain metastases of SBA. Dabaja <jats:italic>et al</jats:italic>. reported 1 case of brain metastasis out of 217 SBA cases, but details of the clinical course of the case were unclear. Our case might be the first report covering the full clinical course, pathological findings, and genetic data. Here, we report a very rare case of brain metastasis from poorly differentiated SBA.</jats:p> </jats:sec> <jats:sec id="st2"> <jats:title>Case Description:</jats:title> <jats:p>A 54-year-old man who suffered from abdominal pain and melena visited a nearby hospital. This patient had no risk factors for SBA. He underwent partial resection of the jejunum with regional lymphadenectomy and combined resection of the transverse colon. Pathological diagnosis was poorly differentiated adenocarcinoma, pT4N2M0 Stage IIIB (UICC-TNM: 8<jats:sup>th</jats:sup> edition). One month after curative surgery, liver metastasis was detected by a computed tomography (CT) scan, and then, palliative chemotherapy was started. During the third-line chemotherapy, a brain tumor on the left cerebellum was detected by the CT scan. Tumor resection was performed, and the histopathological features coincided with the primary jejunum tumor. Based on surgical, radiological, pathological, and genetic findings, this brain tumor was comprehensively diagnosed as a metastasis from poorly differentiated SBA.</jats:p> </jats:sec> <jats:sec id="st3"> <jats:title>Conclusion:</jats:title> <jats:p>Here, we experienced a very rare case of brain metastasis from poorly differentiated SBA.</jats:p> </jats:sec>

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