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Case Reports in Surgery
Volume 2014 (2014), Article ID 126924, 7 pages
http://dx.doi.org/10.1155/2014/126924
Case Report

Jejunal Cancer with WRN Mutation Identified from Next-Generation Sequencing: A Case Study and Minireview

1Department of Molecular Pharmacology, City of Hope National Medical Center and Beckman Research Center, 1500 E Duarte Road, Duarte, CA 91010, USA
2Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan

Received 4 April 2014; Accepted 31 May 2014; Published 15 June 2014

Academic Editor: David J. Bentrem

Copyright © 2014 Christopher Chang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Small bowel cancer is a rare, gastrointestinal cancer originating from the small intestines. Carcinogenesis in the jejunum, the middle segment of the small intestines, occurs less commonly than in the duodenum and ileum. Despite the increasing incidences globally, the cancer is still poorly understood, which includes lack of pathological understanding and etiological reasoning, as it seems to exhibit both similarities and differences with other types of cancers. A 76-year-old Asian man was presented with abdominal pain, which was later attributed to an adenocarcinoma in the jejunum. Initial immunoreactive staining results found no connections to colorectal cancer. The microsatellite instability test was further examined by immunohistochemistry which revealed them to be wild-type. From our exome-capture sequencing results, mutations of WRN may be important as they represent the only genetic defect in this jejunal cancer. The patient has since undergone surgical resection of his cancer and is currently being treated with chemotherapy. The pathology, genomic markers, and treatments are described along with literature review.