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Malignant Neoplasm of the Small Intestine

Small Intestine Cancer


Presentation

  • Large-bowel disease presenting as small-bowel obstruction is associated with a poor prognosis.[cancerindex.org]
  • Nausea, vomiting, and intestinal obstruction are common presenting symptoms. Half of these patients undergo emergency surgery for intestinal obstruction. Abdominal pain and weight loss complicate the clinical presentation. Bleeding is less common.[emedicine.medscape.com]
  • A far less common presenting symptom is bowel obstruction, in which the tumor blocks the passage of food products through the bowel. The blockage could be complete or partial.[oncolink.org]
  • In one analysis of 77 consecutive patients with primary small bowel malignancy over 22 years, average delays were 2 months before presentation to primary care physicians, 8 months from presentation until appropriate investigation, and 12 months from presentation[mja.com.au]
  • It can present as a small submucosal nodule with arterial enhancement (image) and sometimes they lead to intussusception. GIST Typical GIST in the ileum presenting as an exophytic tumor.[radiologyassistant.nl]
Fatigue
  • Some side effects of chemotherapy are: nausea and vomiting loss of appetite temporary hair loss ( alopecia ) mouth sores fatigue, as a result of a low red blood cell count higher likelihood of infection or bleeding due to low white blood cell counts and[encyclopedia.com]
  • They may include abdominal discomfort associated with the following: Nausea Bloating Loss of appetite The following symptoms may indicate advanced disease and should be signs to seek medical attention: Fatigue Weight loss Iron deficiency anemia Visible[emedicinehealth.com]
  • Some common symptoms of cancer that develops in the small intestines include: Abdominal pain Unexplained weight loss Weakness or fatigue (sometimes a result of anemia) Bloody or tarry stools (from bleeding tumors) A noticeable lump in the abdomen Small[cancercenter.com]
  • It is most commonly used in combination with chemotherapy The radiation may be administered by a machine placed outside the body, or by placing a radioactive material inside the body The side effects of radiation therapy include nausea, vomiting, fatigue[dovemed.com]
  • Common symptoms include: crampy abdominal (belly) pain blood mixed in the stools dark/tarry/black stools (from "digested" blood) weight loss diarrhea jaundice weakness fatigue anemia (decreased red blood cell counts) Again, these symptoms could be caused[oncolink.org]
Lymphedema
  • […] disorders you’re born with raise the odds) Smoking and alcohol use High- fat diet Living or working near large quantities of some chemicals, like phenoxyacetic acid Other conditions that affect your gut, like Crohn’s, colon cancer, or celiac disease Lymphedema[webmd.com]
Abdominal Pain
  • Possible signs of small intestine cancer include Abdominal pain Weight loss for no reason Blood in the stool A lump in the abdomen Imaging tests that create pictures of the small intestine and the area around it can help diagnose intestinal cancer and[icdlist.com]
  • People with celiac disease who also have new onset weight loss , diarrhea , or abdominal pain need immediate medical attention, including possible CT scan of the abdomen and barium study of the small bowel to rule out cancer.[emedicinehealth.com]
  • Signs and symptoms of small intestine cancer include unexplained weight loss and abdominal pain. These and other signs and symptoms may be caused by small intestine cancer or by other conditions.[rarecancers.org.au]
  • He was seen several times in the next 9 months, and was then admitted to a general surgical service of a metropolitan hospital with abdominal pain.[mja.com.au]
  • Watery diarrhea and crampy abdominal pain occur in 75-80% of patients with carcinoid syndrome. Cardiac lesions may develop over time and occur in 40% of patients with carcinoid syndrome.[endocrinediseases.org]
Intestinal Disease
  • At last a diagnosis of immunoproliferative small intestinal disease was made.[cancerindex.org]
  • The typical subtype is non-Hodgkin's lymphoma; more specifically MALT lymphomas, large B cell lymphoma, immunoproliferative small intestinal disease, and Burkitt’s lymphoma.[oncolink.org]
  • disease (IPSID, Mediterranean lymphoma or diffuse small intestinal lymphoma ) Various genetic disorders are also associated with an increased incidence of small bowel tumors 1,2 : Peutz-Jeghers syndrome : hamartomatous polyps Gardner's syndrome : adenoma[radiopaedia.org]
  • Following resectable nodal metastases, median survival is 15 years.With non-resectable intestinal disease or liver metastases, survivals are 5 and 3 years, respectively.[surgwiki.com]
  • disease (includes α-heavy chain disease) Western-type B-cell lymphoma of MALT Mantle cell lymphoma Diffuse large B-cell lymphoma Burkitt lymphoma Burkitt-like/atypical Burkitt lymphoma T-cell lymphoma Enteropathy associated Unspecified Others Secondary[abdominalkey.com]
Constipation
  • Bowel obstruction can cause sharp belly pain, sensation of abdominal bloating, vomiting, and, of course, constipation.[oncolink.org]
  • Case Report A 82 years old female with past history of laproscopic cholecystectomy eight years back and hysterectomy two years back for grade III uterine prolapse was admitted with periumbilical pain since 15 days, vomiting 3-4 hours after meals and constipation[tropicalgastro.com]
  • Intestine may include: Presence of tumor that appear like polyps (0.5-2.0 cm in size) Abdominal cramps and swelling Ulceration of the bowel Gastrointestinal bleeding Diarrhea; sometimes there may be bloody diarrhea Vomiting (sometimes with blood), nausea Constipation[dovemed.com]
Abdominal Mass
  • During the last of these admissions, a firm abdominal mass was palpated. A computed tomography (CT) scan revealed an 8 cm heterogeneously enhancing soft tissue mass in the proximal jejunum.[mja.com.au]
  • An abdominal mass is common. Obstruction, perforation, intussusception or haemorrhage occurs in 25% of patients. Malabsorption from diffuse mucosal involvement occurs occasionally.[surgwiki.com]
  • Patients with mesenteric neoplasms usually present with nonspecific symptoms of abdominal pain, weight loss, a palpable abdominal mass, or diarrhea.[ctisus.com]
Hematochezia
  • Treatment • risk for subsequent complications – obstruction – intussusceptions – Hemorrhage - usually occult; hematochezia or hematemesis may occur – For final diagnosis - microscopic evaluation. • polypectomy • Segmental resection and primary anastomosis[slideshare.net]

Workup

  • With MRI spatial resolution less than that achieved with conventional enteroclysis or CT, therefore it is less useful for evaluation of lesions Endoscopic ultrasonography (EUS) is very sensitive and effective for the workup of neoplasms in the ampullary[radiopaedia.org]
  • After extensive pathological review and additional workup consisting of immunohistochemistry and molecular studies, the correct diagnosis of myeloid sarcoma was made.[cancerindex.org]
Small Bowel Mass
  • Double balloon enteroscopy detects small bowel mass lesions missed by capsule endoscopy. Dig Dis Sci 2008;53:2140-3. 15. AK Chong, BW Chin, CG.[pagepress.org]
  • This patient has multiple intraluminal small bowel masses (yellow arrows), which appeared to be metastases from an unknown primary. Also note the intussusception (red arrow) en soft tissue metastasis in the left gluteus muscle (blue arrow).[radiologyassistant.nl]
  • Diagnostic laparoscopy revealed multiple small bowel masses as well as diffuse abdominal and pelvic lymphadenopathy.[cancerindex.org]
  • It provides adequate image quality with multiplanar reformations, allows sufficient distention of the entire small bowel, and provides detailed information about small-bowel masses (size, location, and enhancement) and extraenteric abnormalities (liver[ctisus.com]

Treatment

  • Treatment Options for Small Intestine Cancer For information about the treatments listed below, see the Treatment Option Overview section.[cancer.gov]
  • No two patients are entirely alike, and treatment and responses to treatment can vary greatly.[seer.cancer.gov]
  • After Treatment Get information about how to live well after small intestine cancer treatment and make decisions about next steps.[cancer.org]
  • Trials are often designed to treat a certain stage of cancer, either as the first form of treatment offered, or as an option for treatment after other treatments have failed to work.[oncolink.org]

Prognosis

  • Compared with gastric GISTs, small-bowel GISTs tend to be more aggressive and have a worse prognosis.[emedicine.com]
  • Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery) and treatment options depend on the following: The type of small intestine cancer.[rarecancers.org.au]
  • They occur at younger age and appear to have a better prognosis than sporadic small-bowel cancers.[emedicine.medscape.com]

Etiology

  • Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology.[icd10coded.com]
  • Etiology The strongest known risk factor for small bowel adenocarcinoma is prior Crohn's disease, initially reported by Ginsburg et al., in 1956 ( 26 ).[ncbi.nlm.nih.gov]
  • […] salt-cured or smoked foods, but did not show fruit and vegetable consumption to be protective. 18 Tobacco use and alcohol consumption did not affect development of small intestinal cancer. 18 Table 121-4 Risk Factors for Small Intestinal Tumors Other etiologic[clinicalgate.com]
  • (Etiology) Lymphocytes are a type of white blood cells that are responsible for providing immunity in the human body. B-cells and T-cells are the two different types of lymphocytes.[dovemed.com]
  • However, no specific dietary substance, chemical, or toxin is a demonstrated etiologic agent responsible for adenoma production.[abdominalkey.com]

Epidemiology

  • Epidemiologically, small-bowel adenocarcinomas have a striking resemblance to large-bowel adenocarcinomas.[emedicine.com]
  • Schottenfeld D, Beebe-Dimmer JL,Vigneau FD: The epidemiology and pathogenesis of neoplasia in the small intestine. Ann Epidemiol 2009; 19: 58-69. 2.[degruyter.com]
  • A recent study using the Connecticut Tumor Registry data reviewed the epidemiologic and clinical characteristics of 1260 cases of small intestinal tumors. Of these tumors, 49.8% were found in men; the mean age at presentation was 65.2 years.[clinicalgate.com]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology Approximately 64% of all small-bowel tumors are malignant, and approximately 40% of these tumors are adenocarcinomas. Epidemiologically, small-bowel adenocarcinomas have a striking resemblance to large-bowel adenocarcinomas.[emedicine.com]

Prevention

  • Causes, Risk Factors, and Prevention Learn about the risk factors for small intestine cancer and what you might be able to do to help lower your risk. Early Detection, Diagnosis, and Staging Know the signs and symptoms of small intestine cancer.[cancer.org]
  • […] this report are based on statistics from SEER and the Centers for Disease Control and Prevention's National Center for Health Statistics.[seer.cancer.gov]
  • Prevention Most people who develop cancer do not have inherited genetic abnormalities. Their genes have been damaged after birth by substances in their environment.[encyclopedia.com]
  • How can I prevent small bowel cancer? There are no known ways to prevent small bowel cancer. Since tobacco use is a potential risk factor for developing small bowel cancer, it is important to quit smoking or never start smoking.[oncolink.org]
  • Epidemiology and Prevention. 3rd ed. Oxford University Press; 2006. 801-8. Blanchard DK, Budde JM, Hatch GF 3rd, et al. Tumors of the small intestine. World J Surg. 2000 Apr. 24(4):421-9. [Medline]. Cobrin GM, Pittman RH, Lewis BS.[emedicine.com]

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