Advancedadenocarcinomaofterminalileum:anunusual neoplasmrevealedbyanunusualdiagnostictool

Background and aim: Terminalileumadenocarcinomaisararetumour.Itsincidenceorprevalence among the other sites of gastro-intestinal tract is unknown, since it has been only sporadically described. Since contrast enhanced ultrasonography has been recently used to study bowel alterations in the course of neoplastic or inflammatory disorders, we report here a case of a rare tumour (terminal ileum poorly differ - entiatedadenocarcinoma)inwhichtheinvestigationplayedapivotalroletoobtainadefineddiagnosis. Ma - terials and methods (case report) : Here we report the case of a 62 year old male patient. Due to intestinal oc - clusivesymptomsandbodyweightdecreaseofabout8Kg,heperformedanabdominalcomputedtomogra - phy,intestinalmagneticresonancewithdoublecontrastmedium,colonoscopyandcontrastenhancedultra - sonographyusingasecondgenerationmedium. Results: Inourcasethepeculiaraspectisthatnoarterialen - hancementwasobservedandthefindingremainedunchangedforabout2.48minutesaswellasafterafur - theradministrationof1.5mlofcontrastmedium.Thisaspectwasnotsuggestiveofanactiveinflammation suchasCrohn'sdisease,whereamarkedcontrastmediumenhancementshouldbeexpected. Conclusions: At present it is too speculative to emphasize contrast enhanced ultrasonography as usefulness tool in the diag - nosis of terminal ileum tumors. Nevertheless, our preliminary experience strongly encourages the diffusion ofthemethod.(www.actabiomedica.it)