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Abstract：
BACKGROUND: Sarcomatoid carcinoma of the small intestine is an exceedingly rare and aggressive malignancy, often diagnosed at advanced stages with a poor prognosis. This study documents a detailed case of sarcomatoid carcinoma of the small intestine, highlighting the diagnostic challenges and treatment approaches, underscored by a comprehensive review of related literature. Given the rarity of this condition, our report aims to enrich the existing diagnostic and treatment frameworks for this malignancy, emphasizing the necessity for early detection and intervention strategies. By presenting this case in conjunction with a literature review, we seek to shed light on the elusive nature of sarcomatoid carcinoma in the small intestine and propose avenues for improving patient outcomes.
METHODS: Case presentation A 61-year-old male patient initially presented with recurrent abdominal pain and gastrointestinal symptoms. Initial abdominal computed tomography (CT) scans and gastrointestinal endoscopy revealed only inflammatory and hyperplastic changes in the duodenum and jejunum, with a diagnosis of intestinal obstruction. Two years later, due to gastrointestinal perforation, the patient was hospitalized again.
METHODS: CT scans and other examinations revealed small intestinal lesions. Four small intestinal lesions were surgically removed, and pathology and immunohistochemistry confirmed sarcomatoid carcinoma of the small intestine. A short time later, enhanced CT scans revealed metastatic lesions in the hepatic portal and adrenal glands.
METHODS: After surgery, the gastrointestinal function gradually recovered, and the patient was discharged from the hospital on a semiliquid diet. No further treatment such as radiotherapy or chemotherapy was administered postoperatively.
RESULTS: Five months after the surgery, the patient died due to brain metastasis.
CONCLUSIONS: The study outcomes reveal the aggressive nature of sarcomatoid carcinoma of the small intestine, characterized by rapid progression and poor prognosis despite surgical interventions. The patient condition rapidly deteriorated, leading to metastasis and death within 5 months postsurgery. These findings underscore the critical need for early detection and possibly innovative treatment approaches to improve survival rates. This case also highlights the potential for gastrointestinal sarcomatoid carcinoma to metastasize to distant organs, including the brain, suggesting a propensity for hematogenous spread.
METHODS: Case presentation A 61-year-old male patient initially presented with recurrent abdominal pain and gastrointestinal symptoms. Initial abdominal computed tomography (CT) scans and gastrointestinal endoscopy revealed only inflammatory and hyperplastic changes in the duodenum and jejunum, with a diagnosis of intestinal obstruction. Two years later, due to gastrointestinal perforation, the patient was hospitalized again.
METHODS: CT scans and other examinations revealed small intestinal lesions. Four small intestinal lesions were surgically removed, and pathology and immunohistochemistry confirmed sarcomatoid carcinoma of the small intestine. A short time later, enhanced CT scans revealed metastatic lesions in the hepatic portal and adrenal glands.
METHODS: After surgery, the gastrointestinal function gradually recovered, and the patient was discharged from the hospital on a semiliquid diet. No further treatment such as radiotherapy or chemotherapy was administered postoperatively.
RESULTS: Five months after the surgery, the patient died due to brain metastasis.
CONCLUSIONS: The study outcomes reveal the aggressive nature of sarcomatoid carcinoma of the small intestine, characterized by rapid progression and poor prognosis despite surgical interventions. The patient condition rapidly deteriorated, leading to metastasis and death within 5 months postsurgery. These findings underscore the critical need for early detection and possibly innovative treatment approaches to improve survival rates. This case also highlights the potential for gastrointestinal sarcomatoid carcinoma to metastasize to distant organs, including the brain, suggesting a propensity for hematogenous spread.
摘要：
背景：小肠肉瘤样癌是一种极其罕见且侵袭性的恶性肿瘤，常诊断为晚期，预后不良。这项研究记录了小肠肉瘤样癌的详细病例，强调诊断挑战和治疗方法，通过对相关文献的全面回顾来强调。鉴于这种情况的罕见，我们的报告旨在丰富这种恶性肿瘤的现有诊断和治疗框架，强调早期发现和干预策略的必要性。通过结合文献回顾这个案例，我们试图阐明小肠肉瘤样癌的难以捉摸的性质，并提出改善患者预后的途径。
方法：病例介绍一名61岁男性患者最初表现为复发性腹痛和胃肠道症状。最初的腹部计算机断层扫描（CT）扫描和胃肠内窥镜检查仅显示十二指肠和空肠的炎症和增生性变化，诊断为肠梗阻.两年后,由于胃肠道穿孔,病人再次住院。
方法：CT扫描和其他检查显示小肠病变。手术切除了四个小肠病变，病理及免疫组化证实小肠肉瘤样癌。不久之后，增强CT扫描显示肝门和肾上腺转移性病变。
方法：手术后，胃肠功能逐渐恢复,病人以半液态饮食出院。术后未给予进一步治疗如放疗或化疗。
结果：手术后5个月，患者死于脑转移。
结论：研究结果揭示了小肠肉瘤样癌的侵袭性，尽管进行了手术干预，但进展迅速，预后不良。患者病情迅速恶化，导致术后5个月内转移和死亡。这些发现强调了对早期检测和可能的创新治疗方法以提高生存率的迫切需要。该病例还强调了胃肠道肉瘤样癌转移到远处器官的可能性，包括大脑,提示有血行扩散的倾向.
方法：病例介绍一名61岁男性患者最初表现为复发性腹痛和胃肠道症状。最初的腹部计算机断层扫描（CT）扫描和胃肠内窥镜检查仅显示十二指肠和空肠的炎症和增生性变化，诊断为肠梗阻.两年后,由于胃肠道穿孔,病人再次住院。
方法：CT扫描和其他检查显示小肠病变。手术切除了四个小肠病变，病理及免疫组化证实小肠肉瘤样癌。不久之后，增强CT扫描显示肝门和肾上腺转移性病变。
方法：手术后，胃肠功能逐渐恢复,病人以半液态饮食出院。术后未给予进一步治疗如放疗或化疗。
结果：手术后5个月，患者死于脑转移。
结论：研究结果揭示了小肠肉瘤样癌的侵袭性，尽管进行了手术干预，但进展迅速，预后不良。患者病情迅速恶化，导致术后5个月内转移和死亡。这些发现强调了对早期检测和可能的创新治疗方法以提高生存率的迫切需要。该病例还强调了胃肠道肉瘤样癌转移到远处器官的可能性，包括大脑,提示有血行扩散的倾向.
