Zhong MY, Jian GL, Ye JY, Chen KX, Huang WJ. Ultrasound diagnosis of small bowel adenocarcinoma in Crohn’s disease: A case report and review of literature. World J Gastrointest Oncol 2025; 17(7): 108258 [DOI: 10.4251/wjgo.v17.i7.108258]
Corresponding Author of This Article
Wei-Jun Huang, PhD, Department of Ultrasound, First People's Hospital of Foshan, No. 81 Lingnan Avenue North, Chancheng District, Foshan 528000, Guangdong Province, China. hwjun1716@163.com
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Jul 15, 2025; 17(7): 108258 Published online Jul 15, 2025. doi: 10.4251/wjgo.v17.i7.108258
Ultrasound diagnosis of small bowel adenocarcinoma in Crohn’s disease: A case report and review of literature
Min-Ying Zhong, Guo-Liang Jian, Jie-Yi Ye, Ke-Xin Chen, Wei-Jun Huang
Min-Ying Zhong, Guo-Liang Jian, Jie-Yi Ye, Ke-Xin Chen, Wei-Jun Huang, Department of Ultrasound, First People's Hospital of Foshan, Foshan 528000, Guangdong Province, China
Co-first authors: Min-Ying Zhong and Guo-Liang Jian.
Author contributions: Zhong MY performed the literature review and wrote the manuscript; Zhong MY and Chen KX contributed to data curation, writing-original draft preparation; Ye JY supervised the writing and revision of the manuscript; Huang WJ and Jian GL approved the final version; all authors read and approved the final manuscript.
Supported by Basic and Applied Basic Research Foundation of Guangdong Province, No. 2023A1515220135; and Guangdong Provincial Medical Science and Technology Project Fund, No. A2023502.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors declare that they have no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wei-Jun Huang, PhD, Department of Ultrasound, First People's Hospital of Foshan, No. 81 Lingnan Avenue North, Chancheng District, Foshan 528000, Guangdong Province, China. hwjun1716@163.com
Received: April 9, 2025 Revised: April 25, 2025 Accepted: June 12, 2025 Published online: July 15, 2025 Processing time: 96 Days and 20.9 Hours
Abstract
BACKGROUND
Crohn's disease (CD)-related small bowel adenocarcinoma (SBA) is a rare adenocarcinoma that is difficult to detect and diagnose in its early stages and is associated with long-standing inflammation, which may predispose patients with CD to SBA. This case report describes a patient with CD who was diagnosed with SBA using intestinal ultrasonography (IUS).
CASE SUMMARY
A 38-year-old male diagnosed with CD since 23 years of age was maintained in remission with mesalamine, although he did not take his medication regularly. The patient presented with recurrent dull abdominal pain, bloating, and a three-month history of diarrhea (3 times per day) with unformed stools. Abdominal examination revealed mildly diffuse tenderness. IUS revealed eccentric thickening (23 mm) in the terminal ileum. The hierarchical structure of the intestinal wall disappeared, revealing the “pseudo-kidney” sign. A stricture was identified in the terminal ileum with dilation of the proximal intestinal tract. Color Doppler flow imaging revealed linear blood flow. Contrast-enhanced ultrasound revealed highly heterogeneous enhancement with rapid washout in ileocecal junction, suggesting malignant transformation of CD with intestinal obstruction. Pathological examination revealed poorly differentiated adenocarcinoma of the ileocecal junction.
CONCLUSION
Active surveillance for SBA using IUS is prudent, given its advantages of real-time dynamic imaging, high-detail resolution, and low cost.
Core Tip: Crohn’s disease (CD)-related small bowel adenocarcinoma (SBA) is a rare adenocarcinoma that is difficult to detect and diagnose in its early stages. Herein, selected features of plain and contrast-enhanced ultrasonography in a case of adenocarcinoma are described. This unusual case and review of the relevant literature aims to contribute to the current knowledge base to improve the diagnosis of CD-related SBA using imaging findings.
