BACKGROUND Crohn's disease(CD)causes a range of digestive symptoms including recurrent diarrhea,abdominalgia,and flatulence,and severely impacts the quality of life of patients.Infliximab,a monoclonal antibody aga...BACKGROUND Crohn's disease(CD)causes a range of digestive symptoms including recurrent diarrhea,abdominalgia,and flatulence,and severely impacts the quality of life of patients.Infliximab,a monoclonal antibody against tumor necrosis factor alpha,has recently been promoted as a therapeutic treatment for CD,but its safety margins remain uncertain.We report a case of rapidly progressive colorectal cancer that was diagnosed in a patient with CD who had previously been treated with infliximab.CASE SUMMARY This case report refers to a 40-year-old male with a 6-year history of CD.The patient underwent transverse colostomy because of inflammatory ileus in 2017.He subsequently received infliximab treatment in 2018.Ten months later,worsening contracture of the transverse colostomy was observed.Imaging tests indicated that the patient may have developed colon cancer with extensive peritoneal implantation.At the same time,colonoscopy revealed a rectal mass and pathological examination indicated well-differentiated adenocarcinoma.Palliative ileostomy was performed to improve defecation in 2019.During the operation,a small nodular mass in the mesentery of the small intestine was identified and pathological examination of the mass revealed advanced adenocarcinoma.The patient was diagnosed with advanced colorectal cancer and administered palliative chemotherapy.He died in June 2020.CONCLUSION We stress the importance of recognizing the possible occurrence of malignance in patients with CD receiving infliximab.展开更多
BACKGROUND Adenocarcinoma has the highest incidence among malignant tumors of the small intestine(SI).Squamous cell carcinoma(SCC)often occurs in organs covered with squamous epithelium.Primary or metastatic SCC origi...BACKGROUND Adenocarcinoma has the highest incidence among malignant tumors of the small intestine(SI).Squamous cell carcinoma(SCC)often occurs in organs covered with squamous epithelium.Primary or metastatic SCC originating from the SI is very rare,with very few cases reported in the literature.CASE SUMMARY This case report involves a 69-year-old man who developed abdominal pain after lunch.After admission,an abdominal computed tomography scan revealed perforation of the alimentary canal and multiple abnormal low-density lesions in the liver.During laparotomy,an approximately 4 cm×3 cm-sized solid tumor was found in the jejunum,located 30 cm from the Treitz ligament,with a perforation.An intestinal segment of approximately 15 cm was removed,including the perforated portion.The pathological result was SCC.In combination with liver imaging,a diagnosis of SI SCC with multiple liver metastases was considered.The patient died from hepatic failure 1 mo after the operation.CONCLUSION SI tumors are very rare compared to those originating in other digestive organs.Due to its insidious onset,the diagnosis of this disease is usually delayed.Clinicians must pay close attention to digestive symptoms such as persistent abdominal pain and melena.展开更多
文摘BACKGROUND Crohn's disease(CD)causes a range of digestive symptoms including recurrent diarrhea,abdominalgia,and flatulence,and severely impacts the quality of life of patients.Infliximab,a monoclonal antibody against tumor necrosis factor alpha,has recently been promoted as a therapeutic treatment for CD,but its safety margins remain uncertain.We report a case of rapidly progressive colorectal cancer that was diagnosed in a patient with CD who had previously been treated with infliximab.CASE SUMMARY This case report refers to a 40-year-old male with a 6-year history of CD.The patient underwent transverse colostomy because of inflammatory ileus in 2017.He subsequently received infliximab treatment in 2018.Ten months later,worsening contracture of the transverse colostomy was observed.Imaging tests indicated that the patient may have developed colon cancer with extensive peritoneal implantation.At the same time,colonoscopy revealed a rectal mass and pathological examination indicated well-differentiated adenocarcinoma.Palliative ileostomy was performed to improve defecation in 2019.During the operation,a small nodular mass in the mesentery of the small intestine was identified and pathological examination of the mass revealed advanced adenocarcinoma.The patient was diagnosed with advanced colorectal cancer and administered palliative chemotherapy.He died in June 2020.CONCLUSION We stress the importance of recognizing the possible occurrence of malignance in patients with CD receiving infliximab.
文摘BACKGROUND Adenocarcinoma has the highest incidence among malignant tumors of the small intestine(SI).Squamous cell carcinoma(SCC)often occurs in organs covered with squamous epithelium.Primary or metastatic SCC originating from the SI is very rare,with very few cases reported in the literature.CASE SUMMARY This case report involves a 69-year-old man who developed abdominal pain after lunch.After admission,an abdominal computed tomography scan revealed perforation of the alimentary canal and multiple abnormal low-density lesions in the liver.During laparotomy,an approximately 4 cm×3 cm-sized solid tumor was found in the jejunum,located 30 cm from the Treitz ligament,with a perforation.An intestinal segment of approximately 15 cm was removed,including the perforated portion.The pathological result was SCC.In combination with liver imaging,a diagnosis of SI SCC with multiple liver metastases was considered.The patient died from hepatic failure 1 mo after the operation.CONCLUSION SI tumors are very rare compared to those originating in other digestive organs.Due to its insidious onset,the diagnosis of this disease is usually delayed.Clinicians must pay close attention to digestive symptoms such as persistent abdominal pain and melena.
