A Case of Aberrant Pancreas Cancer in the Jejunum

A 72-year-old man suffering from vomiting with abdominal pain was diagnosed with ileus. A small intesti-nal enema study revealed obstruction of the jejunum by a tumor. Laboratory tests showed elevated CA19-9 of 70U/ml. Under a diagnosis of cancer of the jejunum, we conducted laparotomy and found an obstruction of the jejunum about 130cm distal from Treitz's ligament. We partially resected the jejunum, including the 4×3 cm tumor and dissected regional lymph nodes. The tumor was mostly covered with intact jejunal mucosa, re-sembling a submucosal tumor. Histopathologically, the diagnosis was tubular adenocarcinoma adjacent to ab-errant pancreas with acinar cells and pancreatic ducts (Heinrich II type). Regional lymph node involvement was confirmed. Pathological diagnosis showed well-differentiated adenocarcinoma, se, n1, ly2, v0, INFγ. To our knowledge, this is the fifth such case reported in the Japanese literature.