Rare Finding: Adenocarcinoma Discovered in 17-Year-Old with Peutz-Jeghers Syndrome, Case Report

These findings of the case report are published in the Indian Journal of Surgery in April 2026.

A 17-year-old male presented with recurrent abdominal pain and symptoms of subacute intestinal obstruction, leading to diagnostic imaging that identified multiple ileo-ileal and ileo-caecal intussusceptions alongside numerous gastrointestinal polyps. Following an emergency exploratory laparotomy and right hemicolectomy that confirmed a well-differentiated adenocarcinoma within a hamartomatous polyp, the patient completed an uneventful recovery and commenced adjuvant chemotherapy alongside a strict regimen of lifelong endoscopic surveillance.

Although the pathology of PJS typically involves benign hamartomatous polyps, the case demonstrates a rare malignant transition to well-differentiated adenocarcinoma. These findings suggest that genetic drivers in this disorder can bypass typical slow-growing patterns to trigger early-onset cancer directly within the gastrointestinal tract of teenage patients.

For clinicians, the case emphasizes the critical necessity of prompt surgical intervention when faced with intussusception in patients with this syndrome, as a conservative approach might overlook hidden and life-threatening malignancies. Furthermore, these clinical findings advocate for a potential reassessment of current global screening intervals, suggesting that traditional surveillance protocols may need to be adjusted to ensure the early detection of such rare malignant shifts in young patient demographics.

Reference

Jha, S., & Tiwari, A. K. (2026). Multiple Small Bowel Intussusceptions Unmasking Adenocarcinoma in Peutz–Jeghers Syndrome: Case Report. Indian Journal of Surgery. Published April 10, 2026.