Small bowel adenocarcinoma of the jejunum: a case report and literature review

World J Surg Oncol. 2016 Jul 4;14(1):177. doi: 10.1186/s12957-016-0932-3.


Background: In practice, small bowel cancer is a rare entity. The most common histologic subtype is adenocarcinoma. Adenocarcinoma of the small bowel (SBA) is challenging to diagnose, often presents at a late stage and has a poor prognosis. The treatment of early-stage SBA is surgical resection. No standard protocol has been established for unresectable or metastatic disease.

Case presentation: We report here on a 26-year-old man with SBA in the jejunum, lacking specific symptoms and with a delay of 6 months in diagnosis. The diagnosis was finally achieved with a combination of balloon-assisted enteroscopy, computed tomography scans, positron emission computed tomography scans and the values of carcino-embryonic antigen and carbohydrate antigen 19-9. The patient underwent segmental intestine with lymph node resection, followed by eight cycles of FOLFOX palliative chemotherapy with good tolerance. As of the 11-month postoperative follow-up, there has been no evidence of recurrent disease.

Conclusions: This case is reported to arouse a clinical suspicion of SBA in patients with abdominal pain of unknown cause. We also provided evidence in this case of a response to palliative chemotherapy with FOLFOX. Because the incidence of SBA is very low, there is a need for further studies to evaluate the possible application of newer investigative agents and strategies to obtain a better outcome within the framework of international collaborations.

Keywords: Diagnosis; FOLFOX; Rarity; Small bowel adenocarcinoma; Surgery.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adenocarcinoma / diagnosis*
  • Adenocarcinoma / drug therapy
  • Adenocarcinoma / surgery
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Chemotherapy, Adjuvant
  • Delayed Diagnosis
  • Fluorouracil / therapeutic use
  • Humans
  • Jejunal Neoplasms / diagnosis*
  • Jejunal Neoplasms / drug therapy
  • Jejunal Neoplasms / surgery
  • Jejunum / surgery
  • Leucovorin / therapeutic use
  • Male
  • Organoplatinum Compounds / therapeutic use


  • Organoplatinum Compounds
  • Leucovorin
  • Fluorouracil

Supplementary concepts

  • Folfox protocol