A case of adenocarcinoma developed in the small intestine with chronic strongyloidiasis.

We experienced a case of intestinal strongyloidiasis complicated by jejunal carcinoma. A Japanese male in his 50s, who has a 7-year medical history of duodenal ulcers, complained of loss of appetite, nausea, vomiting and diarrhea. Computed tomography and gastroduodenal endoscopic examination revealed a stenosis of the duodenum. To remove the stenosis, gastric bypass surgery was performed. The pathological diagnosis of the resected jejunum was strongyloidiasis and well-differentiated adenocarcinoma with subserosal invasion and vascular infiltration. After administration of Ivermectin, Strongyloides stercoralis was not found in any biopsies or in the specimens of the intestine, which were resected due to cancer recurrence 2 years later. There are three possibilities for the reason of coexistence of S. stercoralis and adenocarcinoma: S. stercoralis caused the adenocarcinoma, S. stercoralis moved to the carcinoma, or just coincidence. Although it is difficult to prove a causal relationship between S. stercoralis and adenocarcinoma, this is the first report of adenocarcinoma developed in the jejunum with chronic strongyloidiasis. The number of nematode infections, including strongyloidiasis, is decreasing in Japan, although not worldwide. Therefore, it should be considered in patients with prolonged intestinal ulcers.

Schistosoma mekongi infection in a leiomyosarcoma of the small bowel: a case report.

We report a fortuitous occurrence of a small bowel leiomyosarcoma infected with Schistosoma mekongi in an elderly patient from Kampuchea. S mekongi is endemic in countries along the lower Mekong River basin (Laos, Thailand, and Kampuchea), where its intermediate snail hosts (Lithoglyphopsis aperta) are found. The diagnosis was made by examining the numerous ova that were embedded in the tumor and along the small bowel wall. The ova with their small lateral spines are easily confused with those of Schistosoma japonicum, but are consistently smaller and round. The patient presented with lower gastrointestinal bleeding secondary to tumor invasion of the small bowel rather than from heavy parasitic infection. Because of the spindle-cell morphology of the tumor, an exuberant fibroblastic host reaction to the ova was considered during frozen section examination. Unlike the more common species of schistosoma (eg, Schistosoma mansoni and Schistosoma haematobium) that are associated with the development of malignant neoplasms, we believe our case represents a chance finding and that the possible role of S mekongi infection in the neoplastic process is unlikely.