[A Case of Curative Resection for Primary Small Bowel Cancer and Lymph Node Metastasis Incidentally found during...

The patient was a 51-year-old man. He was diagnosed with cStage Ⅲb descending colon cancer after a positive stool occult blood test, and the patient was referred to our department for laparoscopic left hemicolectomy with D3 lymph node dissection. Intraoperatively, we incidentally found a mass lesion at the end of the ileum and a large hard enlarged lymph node in the nearby mesentery of the small intestine, so we additionally performed a partial resection of the small intestine and dissection of the regional lymph node. Pathological findings showed that the small intestinal lesion was adenocarcinoma of the small intestine. Follow-up abdominal contrast CT showed an enlarged lymph node within the small intestinal mesentery at the origin of the ileocolic artery. The patient was suspected to have lymph node recurrence of small intestinal cancer, and the patient had radical resection with ileal resection with D3 lymph node dissection. Pathological findings showed lymph node recurrence of small intestinal cancer, and postoperative adjuvant chemotherapy(4 couses of CAPOX therapy)was performed. As of 3 years and 10 months postoperatively, the patient is alive without recurrence.