Double primary adenocarcinomas of the jejunum and descending colon with lung metastases presenting rare immunohistochemical phenotypes: a case report.

Abstract	We report a male patient with double advanced tumors in the jejunum and descending colon and multiple lung tumors. The intestinal cancers were surgically resected. Immunoprofiling of the specimens revealed a rare phenotype: the jejunal cancer was positive for cytokeratin (CK) 7, partially positive for CK20, and Cdx-2-negative, whereas the colon cancer was CK7(+), CK20(-), and Cdx-2(-). Biopsied lung tumor was diagnosed as tubular adenocarcinoma, and CK7(+)/CK20(+)/Cdx-2(-). Together with clinical information, we deduced that the jejunal adenocarcinoma had presumably metastasized to the lung. Moreover, postoperative oxaliplatin, including chemotherapy, significantly reduced the lung metastases, suggesting that this regimen is a promising treatment option for advanced small bowel adenocarcinoma.
Authors	Hiroaki Nozawa, Yoshinao Yamada, Yasuhiko Muto, Junji Endo, Masahiro Asakage, Teruaki Oka, Yoichi Furukawa, Masami Arai
Journal	European journal of gastroenterology & hepatology (Eur J Gastroenterol Hepatol) Vol. 22 Issue 2 Pg. 228-33 (Feb 2010) ISSN: 1473-5687 [Electronic] England
PMID	19923997 (Publication Type: Case Reports, Journal Article)
Chemical References	Antineoplastic Agents Biomarkers, Tumor CDX2 Transcription Factor CDX2 protein, human Homeodomain Proteins KRT20 protein, human KRT7 protein, human Keratin-20 Keratin-7 Organoplatinum Compounds Oxaliplatin Leucovorin Fluorouracil
Topics	Adenocarcinoma (chemistry, genetics, secondary, therapy) Antineoplastic Agents (administration & dosage) Antineoplastic Combined Chemotherapy Protocols (therapeutic use) Biomarkers, Tumor (analysis) Biopsy CDX2 Transcription Factor Chemotherapy, Adjuvant Colectomy Colonic Neoplasms (chemistry, genetics, pathology, therapy) Fatal Outcome Fluorouracil (therapeutic use) Homeodomain Proteins (analysis) Humans Immunohistochemistry Jejunal Neoplasms (chemistry, genetics, pathology, therapy) Keratin-20 (analysis) Keratin-7 (analysis) Leucovorin (therapeutic use) Lung Neoplasms (chemistry, genetics, secondary, therapy) Lymph Node Excision Male Middle Aged Neoplasms, Multiple Primary Organoplatinum Compounds (administration & dosage, therapeutic use) Oxaliplatin Phenotype Tomography, X-Ray Computed Treatment Outcome

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