Small Intestinal Carcinoma

The postoperative course was complicated by sepsis, respiratory failure, and prolonged ileus. This case highlights the importance of considering primary gastrointestinal lymphoma in the differential diagnosis of bowel perforation and acute surgical abdomen, particularly in elderly patients presenting emergently.

This case underscores the role of immunotherapy in POLE-mutated tumors regardless of the site of origin and highlights the potential usefulness of molecular profiling in rare malignancies. In line with the agnostic approach used for microsatellite instability, molecular-driven clinical trials should be prioritized over histology-based studies to optimize treatment strategies for these orphan diseases.

P2, N=798, Active, not recruiting, National Cancer Institute (NCI) | Trial primary completion date: May 2027 --> May 2026

P=N/A, N=131, Completed, Fondazione Policlinico Universitario Agostino Gemelli IRCCS

P=N/A, N=845, Active, not recruiting, Sidney Kimmel Comprehensive Cancer Center at Thomas Jefferson University | Recruiting --> Active, not recruiting | Trial completion date: Apr 2026 --> May 2031 | Trial primary completion date: Apr 2026 --> Aug 2028

Histopathology established a high-grade, multifocal GIST (pT4(m)N0) with spindle-to-epithelioid morphology, increased mitotic activity, necrosis, strong CD117 and DOG1 positivity, and an elevated Ki-67 labeling index. This case highlights the characteristic radiologic features of ruptured GIST and demonstrates close radiologic-pathologic concordance in an aggressive presentation.

Pathology thus represented the diagnostic cornerstone. This case contributes to the limited literature describing MRI features of small bowel leiomyosarcoma presenting with adult intussusception and underscores the importance of a multimodal diagnostic approach, in which MRI serves as an adjunct to CT, while histopathology remains essential for definitive diagnosis.

Higher LNR was significantly associated with adverse tumor characteristics, including features of the tumor microenvironment such as TB, DR, and TILs. LNR and pre-operative CEA level outperformed nodal stage and other histologic factors as prognostic markers in SIA.

Adjuvant chemotherapy correlates with an extended median OS and RFS, as well as a reduced risk of recurrence and mortality in patients who have undergone surgical resection for DA. Specifically, patients with DA who are in the N1 or N2 stage, or those with a CA199≥27U/mL at their initial diagnosis, may show potential clinical benefits from adjuvant chemotherapy as a preliminary exploratory finding.

P2, N=15, Terminated, National Cancer Institute (NCI) | N=80 --> 15 | Trial completion date: Feb 2029 --> Apr 2026 | Suspended --> Terminated | Trial primary completion date: Jan 2029 --> Mar 2026; Protocol has been completed prematurely due to poor accrual and study feasibility.

P2, N=818, Active, not recruiting, National Cancer Institute (NCI) | Trial completion date: May 2026 --> May 2027 | Trial primary completion date: May 2026 --> May 2027

P1, N=18, Recruiting, Thomas Jefferson University | Not yet recruiting --> Recruiting | Trial completion date: Jan 2027 --> Apr 2028 | Trial primary completion date: Jan 2027 --> Oct 2027