Small Bowel Adenocarcinoma as the Cause of Gastrointestinal Bleeding in Celiac Disease: A Rare Malignancy in a Common Disease

Introduction. Celiac disease is associated with an increased risk of small bowel malignancies, particularly lymphoma. Its association with small bowel carcinoma is less known. Case Description. We report a case of an 89-year-old woman with celiac disease who experienced recurrent episodes of gastroi...

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Main Authors: Jaleh Fallah, Maxwell Eyram Afari, Alfredo C. Cordova, Adam J. Olszewski, Taro Minami
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Case Reports in Oncological Medicine
Online Access:http://dx.doi.org/10.1155/2015/865383
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author Jaleh Fallah
Maxwell Eyram Afari
Alfredo C. Cordova
Adam J. Olszewski
Taro Minami
author_facet Jaleh Fallah
Maxwell Eyram Afari
Alfredo C. Cordova
Adam J. Olszewski
Taro Minami
author_sort Jaleh Fallah
collection DOAJ
description Introduction. Celiac disease is associated with an increased risk of small bowel malignancies, particularly lymphoma. Its association with small bowel carcinoma is less known. Case Description. We report a case of an 89-year-old woman with celiac disease who experienced recurrent episodes of gastrointestinal bleeding and was ultimately found to have adenocarcinoma of the small intestine. Discussion and Evaluation. Diagnosis of small bowel adenocarcinoma is often delayed because of the need for specialized modalities, which are often deferred in the inpatient setting. Although resection is the modality of choice for small bowel tumors, a majority is either locally advanced or metastatic at diagnosis, and even localized cancers have worse prognosis than stage-matched colorectal tumors. The role of adjuvant chemotherapy is uncertain, but it is often offered extrapolating data from other gastrointestinal cancers. Small bowel carcinomas occurring in the context of celiac disease appear to be associated with higher rates of microsatellite instability than sporadic tumors, although other specific genomic abnormalities and mechanisms of carcinogenesis in celiac disease remain unknown. Conclusion. Recurrent episodes of gastrointestinal bleeding in a patient with celiac disease should prompt an early evaluation of the small bowel to assure timely diagnosis of carcinoma at an early curable stage.
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spelling doaj-art-c591a574bc074ba7a6237a9feec3dbe82025-02-03T01:20:45ZengWileyCase Reports in Oncological Medicine2090-67062090-67142015-01-01201510.1155/2015/865383865383Small Bowel Adenocarcinoma as the Cause of Gastrointestinal Bleeding in Celiac Disease: A Rare Malignancy in a Common DiseaseJaleh Fallah0Maxwell Eyram Afari1Alfredo C. Cordova2Adam J. Olszewski3Taro Minami4Department of Medicine, Memorial Hospital of Rhode Island, Pawtucket, RI 02860, USADepartment of Medicine, Memorial Hospital of Rhode Island, Pawtucket, RI 02860, USAThe Warren Alpert Medical School of Brown University, Pawtucket, RI 02860, USADepartment of Medicine, Memorial Hospital of Rhode Island, Pawtucket, RI 02860, USAThe Warren Alpert Medical School of Brown University, Pawtucket, RI 02860, USAIntroduction. Celiac disease is associated with an increased risk of small bowel malignancies, particularly lymphoma. Its association with small bowel carcinoma is less known. Case Description. We report a case of an 89-year-old woman with celiac disease who experienced recurrent episodes of gastrointestinal bleeding and was ultimately found to have adenocarcinoma of the small intestine. Discussion and Evaluation. Diagnosis of small bowel adenocarcinoma is often delayed because of the need for specialized modalities, which are often deferred in the inpatient setting. Although resection is the modality of choice for small bowel tumors, a majority is either locally advanced or metastatic at diagnosis, and even localized cancers have worse prognosis than stage-matched colorectal tumors. The role of adjuvant chemotherapy is uncertain, but it is often offered extrapolating data from other gastrointestinal cancers. Small bowel carcinomas occurring in the context of celiac disease appear to be associated with higher rates of microsatellite instability than sporadic tumors, although other specific genomic abnormalities and mechanisms of carcinogenesis in celiac disease remain unknown. Conclusion. Recurrent episodes of gastrointestinal bleeding in a patient with celiac disease should prompt an early evaluation of the small bowel to assure timely diagnosis of carcinoma at an early curable stage.http://dx.doi.org/10.1155/2015/865383
spellingShingle Jaleh Fallah
Maxwell Eyram Afari
Alfredo C. Cordova
Adam J. Olszewski
Taro Minami
Small Bowel Adenocarcinoma as the Cause of Gastrointestinal Bleeding in Celiac Disease: A Rare Malignancy in a Common Disease
Case Reports in Oncological Medicine
title Small Bowel Adenocarcinoma as the Cause of Gastrointestinal Bleeding in Celiac Disease: A Rare Malignancy in a Common Disease
title_full Small Bowel Adenocarcinoma as the Cause of Gastrointestinal Bleeding in Celiac Disease: A Rare Malignancy in a Common Disease
title_fullStr Small Bowel Adenocarcinoma as the Cause of Gastrointestinal Bleeding in Celiac Disease: A Rare Malignancy in a Common Disease
title_full_unstemmed Small Bowel Adenocarcinoma as the Cause of Gastrointestinal Bleeding in Celiac Disease: A Rare Malignancy in a Common Disease
title_short Small Bowel Adenocarcinoma as the Cause of Gastrointestinal Bleeding in Celiac Disease: A Rare Malignancy in a Common Disease
title_sort small bowel adenocarcinoma as the cause of gastrointestinal bleeding in celiac disease a rare malignancy in a common disease
url http://dx.doi.org/10.1155/2015/865383
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