Small bowel malignancies are a rare clinical entity and accounts for only 1-3% of GI malignancies. Adenocarcinoma is the most common histopathological variety but its frequency decreases at distal locations. Most of small bowel neoplasms are asymptomatic until they become large and hence delay the diagnosis.

We report a case of an ileal adenocarcinoma in a 65 year old male patient who presented with complains of pain abdomen and vomiting since 5 days. Investigations revealed small bowel obstruction. On exploration it was found to be ileal mass. Right hemicolectomy was done with en-bloc removal of distal ileal mass. Histopathology revealed ileal adenocarcinoma.

This rare entity is associated with a nonspecific clinical presentation that contributes to delayed diagnosis and treatment, and consequently to a worse prognosis. Approximately half of the cases are only diagnosed at surgery. Primary treatment consists of wide resection with regional lymphadenectomy. The role of adjuvant chemotherapy has yet to be determined.

This case demonstrates an unusual condition characterized by late and challenging diagnosis and we highlight the importance of an earlier diagnosis and optimal treatment for improved patient outcomes.

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Dr Shrinath

B.J.G.M.C