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A 65-year-old man with a history of colon cancer that was resected 10 years ago presented with small bowel obstruction. During emergency laparotomy, two stenotic, napkin ring-like lesions were seen within a 50.0 cm loop of small bowel that was subsequently resected. There was no intraoperative evidence of tumor elsewhere. Immunostains show the tumor cells to be positive for cytokeratin and CDX-2, and negative for chromogranin and synaptophysin.
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• Adenocarcinoma of small bowel, arising
in celiac disease
• Gastrointestinal stromal tumor (GIST)
• Metastatic medullary carcinoma
• Moderately differentiated neuroendocrine
tumor (atypical carcinoid)
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