Hansen R M, Lewis J D, Janjan N A, Komorowski R A
Department of Medicine, Medical College of Wisconsin, Milwaukee.
J Clin Gastroenterol. 1988 Apr;10(2):213-7. doi: 10.1097/00004836-198804000-00023.
A fifty-year-old woman with abdominal pain, diarrhea, and weight loss ultimately required exploratory laparotomy. The entire small intestine was extensively infiltrated by poorly differentiated adenocarcinoma; mesenteric lymph nodes and surrounding omentum were involved, but no extragastrointestinal tumor was found. A presumptive diagnosis of unresectable primary carcinoma of the small bowel was made. Chemotherapy was initiated with 5-fluorouracil 300 mg/m2/day by continuous intravenous infusion. Nine months later a left breast mass with multiple ipsilateral axillary and supraclavicular lymph nodes developed; biopsy revealed a poorly differentiated adenocarcinoma morphologically identical to the tumor involving her small bowel. In spite of breast irradiation and systemic hormonal therapy, the patient deteriorated rapidly and died from progressive metastatic disease.
一名50岁女性，伴有腹痛、腹泻和体重减轻，最终需要进行剖腹探查术。整个小肠被低分化腺癌广泛浸润；肠系膜淋巴结和周围网膜受累，但未发现胃肠道外肿瘤。初步诊断为不可切除的小肠原发性癌。开始采用5-氟尿嘧啶300mg/m²/天持续静脉输注进行化疗。九个月后，左侧乳房出现肿块，同侧腋窝和锁骨上有多个淋巴结；活检显示为低分化腺癌，形态与累及小肠的肿瘤相同。尽管进行了乳房放疗和全身激素治疗，患者病情仍迅速恶化，死于进行性转移性疾病。
