Abstract
Long standing coeliac disease is associated with an increased risk of malignancy, not only of intestinal lymphoma but also small intestinal adenocarcinoma. Two patients whose initial presentation was adenocarcinoma of the small bowel, but who were subsequently found to have coeliac disease after Whipple's resection, are described. The diagnosis was made early in the postoperative period in the first patient after close histological examination of the tumour-free mucosal margins. This patient was placed on a gluten-free diet and had an uncomplicated postoperative recovery with rapid weight gain. Diagnosis and dietary intervention in the second patient was very delayed and resulted in the development of severe malabsorption and weight loss. This illustrates the importance of ruling out coeliac disease prior to surgery in patients with small intestinal malignancies.
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- Barclay T. H., Schapira D. V. Malignant tumors of the small intestine. Cancer. 1983 Mar 1;51(5):878–881. doi: 10.1002/1097-0142(19830301)51:5<878::aid-cncr2820510521>3.0.co;2-v. [DOI] [PubMed] [Google Scholar]
- Cooper B. T., Holmes G. K., Cooke W. T. Lymphoma risk in coeliac disease of later life. Digestion. 1982;23(2):89–92. doi: 10.1159/000198692. [DOI] [PubMed] [Google Scholar]
- Farrell D. J., Shrimankar J., Griffin S. M. Duodenal adenocarcinoma complicating coeliac disease. Histopathology. 1991 Sep;19(3):285–287. doi: 10.1111/j.1365-2559.1991.tb00039.x. [DOI] [PubMed] [Google Scholar]
- Ferguson A., Arranz E., O'Mahony S. Clinical and pathological spectrum of coeliac disease--active, silent, latent, potential. Gut. 1993 Feb;34(2):150–151. doi: 10.1136/gut.34.2.150. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Holmes G. K., Dunn G. I., Cockel R., Brookes V. S. Adenocarcinoma of the upper small bowel complicating coeliac disease. Gut. 1980 Nov;21(11):1010–1015. doi: 10.1136/gut.21.11.1010. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lioe T. F., Biggart J. D. Primary adenocarcinoma of the jejunum and ileum: clinicopathological review of 25 cases. J Clin Pathol. 1990 Jul;43(7):533–536. doi: 10.1136/jcp.43.7.533. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Marignani M., Levin M. F., Bach D. B., Sinha R. Residents' corner. Answer to case of the month #22. Diagnosis. Celiac disease complicated by adenocarcinoma. Can Assoc Radiol J. 1993 Dec;44(6):481–484. [PubMed] [Google Scholar]
- Pelli M. A., Cavalletti M. L., Bassotti G., Ribacchi F., Morelli A. Adenocarcinoma of the duodenal bulb in a young coeliac woman. Ital J Gastroenterol. 1993 Apr;25(3):121–122. [PubMed] [Google Scholar]
- Perzin K. H., Bridge M. F. Adenomas of the small intestine: a clinicopathologic review of 51 cases and a study of their relationship to carcinoma. Cancer. 1981 Aug 1;48(3):799–819. doi: 10.1002/1097-0142(19810801)48:3<799::aid-cncr2820480324>3.0.co;2-q. [DOI] [PubMed] [Google Scholar]
- Selby W. S., Gallagher N. D. Malignancy in a 19-year experience of adult celiac disease. Dig Dis Sci. 1979 Sep;24(9):684–688. doi: 10.1007/BF01314465. [DOI] [PubMed] [Google Scholar]
- Straker R. J., Gunasekaran S., Brady P. G. Adenocarcinoma of the jejunum in association with celiac sprue. J Clin Gastroenterol. 1989 Jun;11(3):320–323. doi: 10.1097/00004836-198906000-00015. [DOI] [PubMed] [Google Scholar]
- Swinson C. M., Slavin G., Coles E. C., Booth C. C. Coeliac disease and malignancy. Lancet. 1983 Jan 15;1(8316):111–115. doi: 10.1016/s0140-6736(83)91754-3. [DOI] [PubMed] [Google Scholar]