Small bowel tumors

Abstract

SUMMARY
Small intestinal neoplasms are uncommonly encountered
in clinical practice. Small intestinal neoplasms may occur
sporadically, or in association with genetic diseases such
as familial adenomatous polyposis coli or Peutz-Jeghers
syndrome, or in association with chronic intestinal inflammatory
disorders such as Crohns disease or celiac sprue.
Benign small intestinal tumors such as leiomyoma, lipoma,
hamartoma or desmoid tumor, are usually asymptomatic
but may present with intussception. Primary malignancies
of the small intestine, including adenocarcinoma,
leiomyosarcoma, carcinoid, and lymphoma, may present
with intestinal obstruction, jaundice, bleeding, or pain. Extraintestinal
neoplasms may involve the intestine via contiguous
spread or peritoneal metastasis. Hematogenous metastases
to the intestine from an extraintestinal primary
are unusual and are most typical of melanoma. Because
the small intestine is relatively inaccessible to routine endoscopy,
diagnosis of small intestinal neoplasms is often
delayed for months after onset of symptoms. When the diagnosis
is suspected, enteroclysis is the most useful imaging
study. Small bowel endoscopy (enteroscopy) is increasingly
widely available and may permit earlier, non-operative
diagnosis.