Primary Small Intestinal Cancer after Two Resections for Dissemination of Colon Cancer

A 73-year-old woman underwent subtotal colectomy with D2 lymph node dissection for invagination due to ascending colon cancer and perforative peritonitis 7 years previously. The patient underwent 2 surgeries for dissemination; the first was 3 years previously, followed by a second surgery 1 year previously. At this time, she complained of abdominal pain. Abdominal CT showed obstruction in the small intestine with enhanced tumor. Dissemination of ascending colon cancer was suspected and partial resection of the ileum was performed. On the resected specimen, type 1 tumor was identified, which did not invade the serosal membrane side. Pathological findings revealed that papillary adenocarcinoma continued to the small intestine epithelium, and the tumor was diagnosed as primary small intestinal cancer. Her postoperative course was uneventful, and she was discharged on postoperative day 31. Presently, she is alive after 14 months without tumor recurrence or metastasis. Patients that present with small intestinal cancer after colorectal cancer are very rare. However, the number of patients with cancer of other organs after colorectal cancer has been increasing. It is important to pay attention not only to recurrence, but also to cancer of other organs including the small intestine.