Open AccessA case of small bowel adenocarcinoma in a patient with Crohn’s disease detected by PET/CT and double-balloon enteroscopy
Author(s) -
Chise Kodaira,
Satoshi Osawa,
Chihiro Mochizuki,
Yoshihiko Sato,
Masafumi Nishino,
Takanori Yamada,
Yasuhiro Takayanagi,
Kosuke Takagaki,
Ken Sugimoto,
Shigeru Kanaoka,
Takahisa Furuta,
Mutsuhiro Ikuma
Publication year - 2009
Publication title -
world journal of gastroenterology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.15.1774
Subject(s) - medicine , enteroscopy , double balloon enteroscopy , crohn's disease , melena , radiology , adenocarcinoma , positron emission tomography , ileocecal valve , gastroenterology , inflammatory bowel disease , colorectal cancer , population , cancer , endoscopy , ileum , disease , environmental health
Small bowel adenocarcinoma (SBA) in patients with Crohn's disease (CD) is quite rare, difficult to diagnose without surgery, and has a poor prognosis. Here, we report a 48-year-old man with SBA and a 21-year history of CD who was diagnosed by a combination of positron emission tomography/computed tomography (PET/CT) and double-balloon enteroscopy (DBE). Since the age of 27 years, the patient had been treated for ileal CD and was referred to our hospital with persistent melena. Multiple hepatic tumors were found by CT. PET/CT detected an accumulation spot in the small bowel. DBE revealed an ulcerative tumor in the ileum about 100 cm from the ileocecal valve. An endoscopic forceps biopsy specimen showed poorly differentiated adenocarcinoma. There were some longitudinal ulcer scars near the tumor, and the chronic inflammation in the small bowel appeared to be associated with the cancer development. Previous reports suggest the risk of SBA in patients with CD is higher than in the overall population. Since early diagnosis is extremely difficult in these cases, novel techniques, such as PET/CT and DBE, may be expected to help in making a preoperative diagnosis of the development of SBA in CD.