Tumors of the small bowel

Abstract

1. 1. A total of thirty-six primary tumors of the small bowel, twelve malignant and twenty-four benign, were treated over a period of thirty-three years. Of these, eighteen were discovered incidentally at autopsy or in surgical specimens extirpated for other lesions, and eighteen produced symptoms leading to their detection. 2. 2. Benign tumors of the small bowel often are asymptomatic, but malignant neoplasms almost always produce symptoms. Gastrointestinal bleeding, abdominal pain or intestinal obstruction are the usual presenting syndromes. Pain is by far, the most common symptom and is usually epigastric, recurrent and crampy. The presence of anemia strongly suggests that the small bowel neoplasm is malignant, as does a palpable abdominal mass. 3. 3. Roentgenologic study undertaken in sixteen patients provided evidence of small bowel derangement in ten instances. The studies performed were plain films of the abdomen, roentgenograms of the stomach and duodenum, small bowel series and barium enema examination. 4. 4. Surgical excision is the preferred treatment for all patients with neoplasms of the small bowel. Excision for malignant lesions should include wide resection of the adjacent mesentery. Radiation also has been suggested for lymphoid tumors. 5. 5. Of twelve patients with malignant small bowel neoplasms only two are known to be free of disease. These patients had leiomyosarcoma and a carcinoid tumor, and are living twenty-five and thirty months, respectively. Both of these are slow growing neoplasms, and the patients cannot be considered cured at this early date. 6. 6. Of the malignant small bowel neoplasms leiomyosarcomas and carcinoid tumors have the longest survival time and adenocarcinomas and lymphosarcomas the shortest.