- 期刊
Synchronus Multicentric Small Intestinal Adenocarcinomas: Report of a Case
多發性小腸腺癌：一病例報告
摘要
小腸腫瘤非常少見，而多發性小腸腺癌更是極端不平常。小腸惡性腫瘤以腺癌和類上皮癌最常見，而其它惡性腫瘤則包括淋巴癌和橫紋肌肉瘤較常見。 我們呈現這名50歲的男性病人因消化道不明原因的出血而就診，經檢查發現為小腸多發性線癌，腫瘤主要影響十二指腸末端及空腸部份，病人家屬並無惡性腫瘤的病史，雖然胸部X光發現右上肺葉有腫瘤陰影，可是經細針穿刺細胞學檢查兩次，並發現無惡性腫瘤，且肺部病灶已追蹤十多年並無變化。所以不是肺癌的轉移。 我們使用膠囊內視鏡配合傳統小腸鏡診斷出十二指腸末端到空腸多發性腺癌，在確定無擴散的情況下，病人接受手術治療並配合術中內視鏡將所有腫瘤切除，而後三年追蹤並未發現腫瘤複發且病人未再有血便的情形。
並列摘要
Small intestinal tumor is rare; even multiple adenocarinomas limited to the small intestine are extremely uncommon. Adenocarcinoma together with carcinoid tumours are the most common histological types of cancer of the small intestine but patients may present with other primary malignant tumours, including lymphoma and leiomyosarcoma. We report a case of multicentric synchronus small intestinal adenocarcinomas involving from duodenum to jejunum in a 50 year-old man. The patient is well in the past and no family history of malignancy. Chest X-ray had revealed mass lesion in the right upper lung. The pathology examination of echo guide aspiration showed negative. Capsule endoscope and push small intestinal endoscopy was performed and revealed three tumors from duodenum to jejunum. The pathology examination showed moderately differentiated adenocarcinoma. Surgical resection of all three tumors and the patient's abdomen symptoms subsided hence after. No tumor recurred during the follow up to three years after discharge.