A CASE OF PRIMARY CARCINOMA OF THE JEJUNUM ASSOCIATED WITH INTUSSUSCEPTION AND CEREBRAL METASTASIS

We have recently encountered a case of primary carcinoma of the jejunum associated with intussusception and cerebral metastasis. A 55-year-old man was admitted to our hospital, with a chief complaint of hypochondralgy. Although barium studies failed to demonstrate abnormal findings, whole body CT scan revealed mass shadow in the tail of the pancreas with elevation of serum CA19-9 levels, and primary tumor of the pancreas was suspected. The patient developed ileus soon after admission, and urgent surgery showed polipoid tumor associated with intussusception in the jejunum about 100cm distal from the ligament of Treitz. The resectedtumor was histologically diagnosed as pooly differentiated adenocarcinoma of jejunum and tumor metastasis in the regional lymphnodes and the tail of the pancreas. In the postoperative period, the patient complained of the headache, and tumor shadow was pointed out on the CT scan of the head. Craniotomy was performed, but the patient died of the cancer two months later. Primary carcinoma of the small intestine is an infrequently encountered tumor that is difficult to diagnose preoperatively. The tumor is rarely associated with intussusception or cerebral metastasis. These characteristic features are reviewed and discussed.