Skip to main content

Advertisement

SpringerLink
Log in

Primary undifferentiated carcinoma of the small intestine: an immunohistochemical study and review of the literature

  • Original Paper
  • Published:
Medical Molecular Morphology Aims and scope Submit manuscript

Abstract

Primary undifferentiated carcinoma of the small intestine is an extremely rare neoplasm. Here, we report a case of primary undifferentiated carcinoma that arose from the ileum in a 65-year-old woman. Laboratory data revealed anemia and slightly elevated inflammatory parameters. Computed tomography showed a heterogeneous mass in the pelvic cavity, and magnetic resonance imaging revealed that the margin of the tumor mass was clear. Positron emission tomography using 18F-fluoro-2-deoxy-d-glucose (FDG) showed accumulation of FDG on the tumor mass with a standardized uptake value of 8.3. Partial resection of the ileum to remove the tumor was performed under a clinical diagnosis of small intestinal carcinoma. The tumor was nodulated and had a circumscribed margin 6.5 × 5.5 × 4 cm in diameter. Microscopically, the tumor was composed of giant polygonal cells with cellular atypia. Immunohistochemical examination revealed that the tumor cells expressed epithelial markers including AE1/AE3, CAM5.2, and EMA; however, lymphocytic, mesenchymal, and gastrointestinal stromal tumor markers were not expressed. We made a final diagnosis of primary undifferentiated carcinoma of the small intestine. The prognosis of patients with undifferentiated carcinoma of the small intestine is very poor. To improve the outcome of treatment, early and accurate diagnosis is essential, and additional therapy, including multimodality adjuvant therapy or the administration of novel molecular targeted drugs, should be considered.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Silberman H, Crichlow RW, Caplan HS (1974) Neoplasms of the small bowel. Ann Surg 180:157–161

    Article  CAS  PubMed  Google Scholar 

  2. Namikawa T, Hanazaki K (2009) Clinical analysis of primary anaplastic carcinoma of the small intestine. World J Gastroenterol 15:526–530

    Article  PubMed  Google Scholar 

  3. Ikeda Y, Matsumura S, Sunagawa K, Watanabe K, Masaoka T, Uegaki K (1979) Primary carcinoma of the small intestine: a report of two cases. J Hiroshima Med Assoc 27:358–362

    Google Scholar 

  4. Sasaki M, Hanatate F, Yamamura K, Munemoto Y, Takabatake I, Murakami S, Hikishima H, Hayashi T, Yamada T, Kitagawa S, Nakagawa M (1988) A case of small intestinal undifferentiated carcinoma with a chief complaint of anemia. Jpn J Gastroenterol Surg 21:2435–2438

    Google Scholar 

  5. Robey-Cafferty SS, Silva EG, Cleary KR (1989) Anaplastic and sarcomatoid carcinoma of the small intestine: a clinicopathologic study. Hum Pathol 20:858–863

    Article  CAS  PubMed  Google Scholar 

  6. Ikeguchi M, Nishidoi H, Kudou H, Murakami S, Masaki T, Taniguchi H, Maeda K (1993) A case of primary ileal undifferentiated carcinoma: clinicopathological study on 95 cases of primary jejunal and ileal carcinoma in Japan. Jpn J Surg Assoc 54:450–454

    Google Scholar 

  7. Amano H, Kuroda Y, Kuranishi F, Urushihara T, Shimokado K, Fujimori M, Kitayama T, Yonehara S (1998) Two cases of primary small intestinal cancer. J Hiroshima Med Assoc 51:739–742

    Google Scholar 

  8. Agrawal S, Trivedi MH, Lukens FJ, Moon C, Ingram EA, Barthel JS (1999) Anaplastic and sarcomatoid carcinoma of the small intestine: an unusual tumor. J Clin Gastroenterol 29:99–101

    Article  CAS  PubMed  Google Scholar 

  9. Nakamura T, Otani Y, Kokuba Y, Kanazawa H, Aihara S, Kakita A (2000) A case of undifferentiated cancer with neuroendocrine differentiation of the small intestine accompanied by multiple small bowel metastases. Jpn J Surg Assoc 61:3271–3275

    Google Scholar 

  10. Kadoya M, Suzuki Y, Hazama K, Nakanishi Y, Kanai M, Takahashi M, Fujita M, Kato H (2003) A case of primary anaplastic carcinoma of the small intestine. Jpn J Gastroenterol Surg 36:1615–1620

    Google Scholar 

  11. Sato Y, Nagatsuka Y, Iwabuchi H, Arai H, Wakayama T, Ogawa T, Tanaka M (2003) A case of synchronous double cancer involving the lung and small intestine. Jpn J Surg Assoc 64:3230–3234

    Google Scholar 

  12. Usuda M, Nakano T, Hirano T, Suzuki H, Mochizuki I, Ono S (2007) A case of undifferentiated carcinoma of the small intestine presenting as fever of unknown origin. Jpn J Surg Assoc 68: 2543–2547

    Article  Google Scholar 

  13. Shiraishi R, Kikkawa A, Sumi K, Hidaka K (2007) A case of primary undifferentiated cancer in the small intestine. Intern Med 100:790–794

    Google Scholar 

  14. Matsuoka T, Katsuragi K, Matsuzaki T, Takashima S, Wakasa K, Okuno M (2008) A case of small bowel anaplastic carcinoma with multiple intramural metastases. Jpn J Gastroenterol Surg 41: 123–128

    Google Scholar 

  15. Talamonti MS, Goetz LH, Rao S, Joehl RJ (2002) Primary cancers of the small bowel: analysis of prognostic factors and results of surgical management. Arch Surg 137:564–571

    Article  PubMed  Google Scholar 

  16. Chaiyasate K, Jain AK, Cheung LY, Jacobs MJ, Mittal VK (2008) Prognostic factors in primary adenocarcinoma of the small intestine: 13-year single institution experience. World J Surg Oncol 6:12

    Article  PubMed  Google Scholar 

  17. Wu TJ, Yeh CN, Chao TC, Jan YY, Chen MF (2006) Prognostic factors of primary small bowel adenocarcinoma: univariate and multivariate analysis. World J Surg 30:391–398

    Article  PubMed  Google Scholar 

  18. Sailer J, Zacherl J, Schima W (2007) MDCT of small bowel tumours. Cancer Imaging 7:224–233

    Article  PubMed  Google Scholar 

  19. Yamamoto H, Sekine Y, Sato Y, Higashizawa T, Miyata T, Iino S, Ido K, Sugano K (2001) Total enteroscopy with a nonsurgical steerable double balloon method. Gastrointest Endosc 53:216–220

    Article  CAS  PubMed  Google Scholar 

  20. Wick MR (2008) Immunohistochemical approaches to the diagnosis of undifferentiated malignant tumors. Ann Diagn Pathol 12: 72–84

    Article  PubMed  Google Scholar 

  21. Vella J, Cracchiolo B, Heller DS (2006) Anaplastic carcinoma arising in an ovarian mucinous cystadenocarcinoma in a 17-yearold female. J Pediatr Adolesc Gynecol 19:39–43

    Article  PubMed  Google Scholar 

  22. Moll R, Franke WW, Schiller DL, Geiger B, Krepler R (1982) The catalog of human cytokeratins: patterns of expression in normal epithelia, tumors and cultured cells. Cell 31:11–24

    Article  CAS  PubMed  Google Scholar 

  23. Kazama S, Watanabe T, Ajioka Y, Kanazawa T, Nagawa H (2006) Tumour budding at the deepest invasive margin correlates with lymph node metastasis in submucosal colorectal cancer detected by anticytokeratin antibody CAM 5.2. Br J Cancer 94:293–298

    Article  CAS  PubMed  Google Scholar 

  24. Bahrami A, Truong LD, Ro JY (2008) Undifferentiated tumor: true identity by immunohistochenistry. Arch Pathol Lab Med 132: 326–348

    PubMed  Google Scholar 

  25. Ouriel K, Adams JT (1984) Adenocarcinoma of the small intestine. Am J Surg 147:66–71

    Article  CAS  PubMed  Google Scholar 

  26. Veyrieres M, Baillet P, Hay JM, Fingerhut A, Bouillot JL, Julien M (1997) Factors influencing long-term survival in 100 cases of small intestine primary adenocarcinoma. Am J Surg 173:237–239

    Article  CAS  PubMed  Google Scholar 

  27. Dabaja BS, Suki D, Pro B, Bonnen M, Ajani J (2004) Adenocarcinoma of the small bowel: presentation, prognostic factors, and outcome of 217 patients. Cancer (Phila) 101:518–526

    Article  Google Scholar 

  28. Neugut AI, Marvin MR, Rella VA, Chabot JA (1997) An overview of adenocarcinoma of the small intestine. Oncology 11:529–536

    CAS  PubMed  Google Scholar 

  29. Bakaeen FG, Murr MM, Sarr MG, Thompson GB, Farnell MB, Nagorney DM, Farley DR, van Heerden JA, Wiersema LM, Schleck CD, Donohue JH (2000) What prognostic factors are important in duodenal adenocarcinoma? Arch Surg 135:635–641

    Article  CAS  PubMed  Google Scholar 

  30. Minardi AJ, Zibari GB, Aultman DF, McMillan RW, McDonald JC (1998) Small-bowel tumors. J Am Coll Surg 186:664–668

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Kochi Medical School, Kohasu-Okocho, Nankoku, Kochi, 783-8505, Japan

    Tsutomu Namikawa, Jun Iwabu, Hiroyuki Kitagawa, Hiromichi Maeda, Takehiro Okabayashi & Kazuhiro Hanazaki

  2. Department of Human Health and Medical Sciences, Kochi Medical School, Kochi, Japan

    Michiya Kobayashi

  3. Laboratory of Diagnostic Pathology, Kochi Medical School Hospital, Kochi, Japan

    Mitsuko Iguchi & Makoto Hiroi

Authors
  1. Tsutomu Namikawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Michiya Kobayashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jun Iwabu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hiroyuki Kitagawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hiromichi Maeda
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Takehiro Okabayashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Mitsuko Iguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Makoto Hiroi
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Kazuhiro Hanazaki
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tsutomu Namikawa.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Namikawa, T., Kobayashi, M., Iwabu, J. et al. Primary undifferentiated carcinoma of the small intestine: an immunohistochemical study and review of the literature. Med Mol Morphol 43, 91–95 (2010). https://doi.org/10.1007/s00795-009-0448-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00795-009-0448-9

Key words

Search

Navigation