In
adenocarcinoma of the small intestine, delays in diagnosis are frequent. The majority of patients present with advancedstage disease, and have either lymph node involvement or distant metastatic disease. Surgical resection is a mainstay in treatment of this disease, and the effectiveness of
chemotherapy for advanced-stage or metastatic disease has been reported. We report a case of
adenocarcinoma of the small intestine surviving for many years after surgical resection and
chemotherapy. A 47-year-old woman underwent a small intestine resection, because she had a small intestinal
tumor with obstruction. Histopathological examination revealed moderately-differentiated
adenocarcinoma with
lymph node metastasis.
Adjuvant chemotherapy with S-1 was administered for a year, but in March 2006, a recurrent lesion at the right ovary was detected, and she underwent right adnexectomy. Because the
ascites cytology revealed class V,
chemotherapy was administered. In December 2008, CA19-9 elevated and magnetic resonance imaging showed a
tumor behind the uterus, which was diagnosed as a recurrent disease. Because the
tumor invaded the rectum, she received a low anterior resection,
hysterectomy, and left adnexectomy. After surgical resection, UFT/UZEL was administered for half a year. In July 2010, computed tomography showed multiple lung
metastases, and
chemotherapy was performed again. However, the regimen was changed because her
tumor marker elevated. She is being treated using a combination of
cisplatin and
irinotecan.