A rare association of adenocarcinoma of the small bowels and coeliac disease: A case report

Abstract

Introduction: Coeliac disease is a long-term autoimmune disorder that primarily affects the small intestine. It is due to an adverse reaction to gluten. The treatment is based on a strict gluten-free diet. Evolution can be marked by the occurrence of malignant complications that can modify the prognosis of the disease by increasing mortality. These complications are dominated by lymphoma; however, carcinomas can occur.

Case presentation: We report the case of a 52-year-old patient with celiac disease. The patient was not respecting the gluten-free diet. She was presented with chronic abdominal pain. Imaging findings promote small bowel neoplasia. The suspicious segment was removed, and it was found to be an adenocarcinoma.

Clinical discussion: Coeliac disease occurrence in adults is rare, and it is reflected by paucisymptomatic forms long misunderstood sometimes revealing malignant complications which are presented essentially by lymphoma. Small bowel adenocarcinoma is extremely rare. Its etiopathogenesis remains unknown.

Conclusion: Adenocarcinomas of the small bowels associated with celiac disease, although uncommon, should be suspected in the face of any recrudescence of symptoms and/or primary or secondary resistance of the strict gluten-free diet.

Keywords: Adenocarcinoma; Coeliac disease; Small bowels.

Fig. 1

CT Scan showing the thickening of the wall of the small bowel.

Fig. 2

Intraoperative view: An agglomeration of the small bowel and multiple mesenteric lymphadenopathies.

Fig. 3

The resected specimen.