Complete Remission from Salvage Volumetric Modulated Arc Therapy in Recurrent Adenocarcinoma of the Jejunum with Retroperitoneal Metastasis Eleven Years after Diagnosis: A Rare Case of Cure.

Small bowel adenocarcinoma (SBA) is rare and carries very poor prognosis if there is metastasis. This case shows the benefit of offering aggressive chemoradiation for recurrent adenocarcinoma of the jejunum with retroperitoneal metastasis to achieve the best quality of life (QoL) and potential cure. A complete response (CR) was observed following volumetric modulated arc therapy (VMAT) to biopsy-proven retroperitoneal lymph node metastasis four years after the initial diagnosis of stage pT4pN1 adenocarcinoma of the jejunum. Retroperitoneal lymph node dissection was not performed due to the excellent local control. There was no residual cancer or further metastasis seen on follow-up computed tomography (CT) imaging. The patient remains cancer free and asymptomatic eleven years after the initial diagnosis.