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Small intestinal adenocarcinoma accompanied by lynch syndrome: A case report
Kyoung Won Yoon1, Jaemin Jo2, Donghyoun Lee3
1Division of Critical Care, Department of Surgery, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong, Republic of Korea.
Rationale:
Lynch syndrome is caused by germline mutations of DNA mismatch repair genes. A significant risk increase for several types of cancer is one of the characteristics of lynch syndrome.
Patient Concerns:
A 45-year-old female presented to the emergency department with abdominal pain that had persisted for a month.
Diagnoses:
The abdominal and pelvic computed tomography scan showed edematous and thickening of the proximal small bowel wall, as well as dilatation of the proximal bowel and stomach.
Interventions:
Tumor resection of the small bowel was performed, and adenocarcinoma was confirmed pathologically. Microsatellite instability was also confirmed.
Outcomes:
Postoperative imaging revealed soft tissue lesions with potential for tumor seeding. Two months after the first surgery, a secondary surgery was performed as a result of cancer recurrence. The patient received chemotherapy with capecitabine. The latest computed tomography scan, performed 19 months after the cessation of chemotherapy, did not show any recurrence.
Lessons:
In the rare incidence of small bowel cancer genetic mutation testing and detailed family history should be actively considered.
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