Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Nov 15, 2022; 14(11): 2295-2301
Published online Nov 15, 2022. doi: 10.4251/wjgo.v14.i11.2295
Rare squamous cell carcinoma of the jejunum causing perforated peritonitis: A case report
Lin Xiao, Lie Sun, Ji-Xin Zhang, Yi-Sheng Pan
Lin Xiao, Lie Sun, Yi-Sheng Pan, Department of General Surgery, Peking University First Hospital, Beijing 100034, China
Ji-Xin Zhang, Department of Pathology, Peking University First Hospital, Beijing 100034, China
Author contributions: Xiao L collected the patient data and drafted the manuscript; Sun L revised the manuscript; Zhang JX performed image processing and wrote the manuscript; all authors read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yi-Sheng Pan, MD, Doctor, Department of General Surgery, Peking University First Hospital, No. 8 Xishiku Street, Beijing 100034, China. bdyypanyisheng@163.com
Received: September 2, 2022
Peer-review started: September 2, 2022
First decision: September 19, 2022
Revised: September 25, 2022
Accepted: October 17, 2022
Article in press: October 17, 2022
Published online: November 15, 2022
Processing time: 74 Days and 2 Hours
Abstract
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.

Keywords: Squamous cell carcinoma; Jejunal perforation; Peritonitis; Abdominal computed tomography scan; Case report

Core Tip: Squamous cell carcinoma (SCC) in the small bowel is a rare pathologic category. Clinical symptoms are not evident, and it is challenging to determine whether it is the small intestine’s primary or metastatic SCC. This paper describes a 69-year-old male patient diagnosed with SCC of the small intestine and hepatic metastases. Effective diagnosis and early treatment are vital in improving the prognosis of malignant small bowel tumors. Radical resection should be undertaken if no metastases are found.