Small-Intestinal Tumors

Small-intestinal tumors arise from duodenum to ileocecal valve (here: jejunum/ileum). Small bowel = 75% of GI length, >90% mucosal area, but only 5% of GI tumors; malignant = ~1% of GI malignancies; primary = 0.2% of all tumors, 3-6% of GI tumors. Etiology unclear.

Common Symptoms

Borborygmus; intestinal perforation; low small-bowel obstruction; hematochezia; intestinal spasm; fatigue; nausea; intussusception; belching

Causes and Pathogenesis

(1) Etiology: (a) adenomatous polyps/adenocarcinoma/hereditary polyposis; (b) anaerobes; (c) IPSID = lymphoma precancer (infection-driven); (d) IBD → malignant; (e) celiac/Crohn/neurofibromatosis/post-ileal surgery → adenocarcinoma; nodular lymphoid hyperplasia/AIDS → non-Hodgkin; (f) dimethylhydrazine/azoxymethane. (2) Mechanism: Pathology: 35 types abroad/20 in China. By differentiation: benign (adenoma/polyp, leiomyoma/adenomyoma, fibroma, lipoma, hemangioma, neurofibroma/neurilemmoma, hamartoma/teratoma/lymphangioma/melanoma); common = adenoma/leiomyoma/lipoma/fibroma/hemangioma (jejunoileal leiomyoma 38-54%). Malignant: carcinoma (adeno/papillary/mucinous), sarcoma (fibro/neurofibro/leiomyo/reticulum-cell/myxoid), carcinoid/argyrophiloma, Hodgkin, malignant hemangioma/melanoma/schwannoma. Carcinoma most common, then sarcoma (malignant lymphoma 35-40%); carcinoma:sarcoma = 1:5.5. By tissue: epithelial vs non-epithelial. Distribution: malignant equal across segments; benign duodenal < jejunum/ileum.

Treatment

Surgery, drug, supportive therapy

Preventive Measures

Malignant small-bowel surgery: wide resection + regional nodes; duodenal = pancreaticoduodenectomy. Unresectable = bypass. Early diagnosis hard; resection rate ~40%; 5-y survival: leiomyosarcoma ~40%, lymphoma ~35%, adenocarcinoma ~20%. Radiation/chemo (except lymphoma) = poor.

Department to Visit

It is recommended to visit the Medical Oncology department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.