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A Challenging Diagnosis of Jejunal Adenocarcinoma in a Celiac Patient: Case Report and Systematic Review of the Literature
Angelo Zullo1, Vincenzo De Francesco2, Raffaele Manta3, Lorenzo Ridola4, Roberto Lorenzetti1

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1) Gastroenterology and Digestive Endoscopy, Nuovo Regina Margherita Hospital, Rome;
2) Section of Gastroenterology, Riuniti Hospitals, Foggia;
3) Gastroenterology Unit, Nuovo Ospedale Civile Sant’Agostino-Estense, Baggiovara-Modena;
4) Gastroenterology Unit, Sapienza University of Rome, Polo Pontino, Latina, Italy

DOI: http://dx.doi.org/10.15403/jgld.2014.1121.264.zet

ABSTRACT
Celiac disease (CD) is a common and chronic disorder requiring a long-life gluten-free diet. There is evidence that asymptomatic or subclinical presentation of CD has increased in the last decades, so that several cases are diagnosed during adulthood or even in the elderly. Celiac disease patients are at an increased risk of developing malignancies, particularly when the disease is diagnosed in the elderly. We describe a case of a challenging diagnosis of small bowel adenocarcinoma which developed in a patient with CD discovered only in the elderly. We also performed a systematic review of the literature. A tailored follow-up in a sub-group of CD patients at an increased risk of developing intestinal adenocarcinoma could be implemented.
Key words: Celiac disease – adenocarcinoma – small bowel – videocapsule endoscopy.
Abbreviations: CD: Celiac disease; GP: General Practitioner; FOBT: faecal occult blood test; EMA: anti-endomysial antibodies; tTG: anti-tissue transglutaminase antibodies; Hgb: hemoglobin; VCE: videocapsule endoscopy.