Conversion surgery for advanced jejunal adenocarcinoma with multiple peritoneal metastases: a case report
Abstract Background Small bowel cancer (SBC) is a rare malignancy that is often diagnosed at an advanced stage. Palliative chemotherapy is the standard treatment for patients with metastatic SBC. The relevant literature on conversion surgery in patients who have responded favorably to chemotherapy i...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SpringerOpen
2023-08-01
|
| Series: | Surgical Case Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40792-023-01716-6 |
| _version_ | 1797556872710979584 |
|---|---|
| author | Miku Obayashi Shimpei Otsuka Ryo Ashida Katsuhisa Ohgi Mihoko Yamada Takeshi Kawakami Katsuhiko Uesaka Teiichi Sugiura |
| author_facet | Miku Obayashi Shimpei Otsuka Ryo Ashida Katsuhisa Ohgi Mihoko Yamada Takeshi Kawakami Katsuhiko Uesaka Teiichi Sugiura |
| author_sort | Miku Obayashi |
| collection | DOAJ |
| description | Abstract Background Small bowel cancer (SBC) is a rare malignancy that is often diagnosed at an advanced stage. Palliative chemotherapy is the standard treatment for patients with metastatic SBC. The relevant literature on conversion surgery in patients who have responded favorably to chemotherapy is limited. Case presentation A 64-year-old man was diagnosed with jejunal carcinoma with multiple peritoneal metastases. After implanting an expandable metallic stent at the primary site, the patient underwent 6 months of FOLFOX therapy, resulting in a clinical complete response. Chemotherapy was continued, and four years after the initiation of therapy, the patient showed no evidence of disease progression. Nevertheless, anemia of continuous minor hemorrhages from the stent site and general malaise of chemotherapy got progressively worse during treatment. After confirming negative ascites cytology and the absence of peritoneal metastasis via staging laparoscopy, the patient underwent partial jejunectomy. Pathologically, no residual tumor was detected in the resected specimen. The postoperative course was uneventful, and the patient remained free of recurrence for 30 months after surgery without chemotherapy. Conclusion Although infrequent, conversion surgery may be a valid therapeutic option for selected cases of SBC with peritoneal metastasis. |
| first_indexed | 2024-03-10T17:09:14Z |
| format | Article |
| id | doaj.art-b0b0626aef4648b9b124105b4024ea42 |
| institution | Directory Open Access Journal |
| issn | 2198-7793 |
| language | English |
| last_indexed | 2024-03-10T17:09:14Z |
| publishDate | 2023-08-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj.art-b0b0626aef4648b9b124105b4024ea422023-11-20T10:43:12ZengSpringerOpenSurgical Case Reports2198-77932023-08-01911610.1186/s40792-023-01716-6Conversion surgery for advanced jejunal adenocarcinoma with multiple peritoneal metastases: a case reportMiku Obayashi0Shimpei Otsuka1Ryo Ashida2Katsuhisa Ohgi3Mihoko Yamada4Takeshi Kawakami5Katsuhiko Uesaka6Teiichi Sugiura7Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer CenterDivision of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer CenterDivision of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer CenterDivision of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer CenterDivision of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer CenterDivision of Gastrointestinal Oncology, Shizuoka Cancer CenterDivision of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer CenterDivision of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer CenterAbstract Background Small bowel cancer (SBC) is a rare malignancy that is often diagnosed at an advanced stage. Palliative chemotherapy is the standard treatment for patients with metastatic SBC. The relevant literature on conversion surgery in patients who have responded favorably to chemotherapy is limited. Case presentation A 64-year-old man was diagnosed with jejunal carcinoma with multiple peritoneal metastases. After implanting an expandable metallic stent at the primary site, the patient underwent 6 months of FOLFOX therapy, resulting in a clinical complete response. Chemotherapy was continued, and four years after the initiation of therapy, the patient showed no evidence of disease progression. Nevertheless, anemia of continuous minor hemorrhages from the stent site and general malaise of chemotherapy got progressively worse during treatment. After confirming negative ascites cytology and the absence of peritoneal metastasis via staging laparoscopy, the patient underwent partial jejunectomy. Pathologically, no residual tumor was detected in the resected specimen. The postoperative course was uneventful, and the patient remained free of recurrence for 30 months after surgery without chemotherapy. Conclusion Although infrequent, conversion surgery may be a valid therapeutic option for selected cases of SBC with peritoneal metastasis.https://doi.org/10.1186/s40792-023-01716-6Jejunal adenocarcinomaSmall bowel cancerPeritoneal metastasesConversion surgeryComplete responseFOLFOX |
| spellingShingle | Miku Obayashi Shimpei Otsuka Ryo Ashida Katsuhisa Ohgi Mihoko Yamada Takeshi Kawakami Katsuhiko Uesaka Teiichi Sugiura Conversion surgery for advanced jejunal adenocarcinoma with multiple peritoneal metastases: a case report Surgical Case Reports Jejunal adenocarcinoma Small bowel cancer Peritoneal metastases Conversion surgery Complete response FOLFOX |
| title | Conversion surgery for advanced jejunal adenocarcinoma with multiple peritoneal metastases: a case report |
| title_full | Conversion surgery for advanced jejunal adenocarcinoma with multiple peritoneal metastases: a case report |
| title_fullStr | Conversion surgery for advanced jejunal adenocarcinoma with multiple peritoneal metastases: a case report |
| title_full_unstemmed | Conversion surgery for advanced jejunal adenocarcinoma with multiple peritoneal metastases: a case report |
| title_short | Conversion surgery for advanced jejunal adenocarcinoma with multiple peritoneal metastases: a case report |
| title_sort | conversion surgery for advanced jejunal adenocarcinoma with multiple peritoneal metastases a case report |
| topic | Jejunal adenocarcinoma Small bowel cancer Peritoneal metastases Conversion surgery Complete response FOLFOX |
| url | https://doi.org/10.1186/s40792-023-01716-6 |
| work_keys_str_mv | AT mikuobayashi conversionsurgeryforadvancedjejunaladenocarcinomawithmultipleperitonealmetastasesacasereport AT shimpeiotsuka conversionsurgeryforadvancedjejunaladenocarcinomawithmultipleperitonealmetastasesacasereport AT ryoashida conversionsurgeryforadvancedjejunaladenocarcinomawithmultipleperitonealmetastasesacasereport AT katsuhisaohgi conversionsurgeryforadvancedjejunaladenocarcinomawithmultipleperitonealmetastasesacasereport AT mihokoyamada conversionsurgeryforadvancedjejunaladenocarcinomawithmultipleperitonealmetastasesacasereport AT takeshikawakami conversionsurgeryforadvancedjejunaladenocarcinomawithmultipleperitonealmetastasesacasereport AT katsuhikouesaka conversionsurgeryforadvancedjejunaladenocarcinomawithmultipleperitonealmetastasesacasereport AT teiichisugiura conversionsurgeryforadvancedjejunaladenocarcinomawithmultipleperitonealmetastasesacasereport |