Small Intestine Cancer
Dongyou Liu in Tumors and Cancers, 2017
The principal symptom of small intestine cancer is chronic intermittent cramp-like abdominal pain, often with nausea and vomiting, melena, diarrhea, fatigue, anorexia, and unexplained weight loss. Iron-deficiency anemia through occult GI bleeding is often the only detectable abnormality. On rare occasions, patients may present acutely with intestinal obstruction, with or without an appreciable abdominal mass or even perforation.
Other Tumours of the Colon and Rectum
Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams in Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
Treatment modality and oncological outcome vary with histological types, but surgery usually represents the first-line therapy. Small bowel gastrointestinal stromal tumours and duodenal neoplasms will not be described in this chapter.
Gastrointestinal tract and salivary glands
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha in Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
In the duodenum CT can play a vital role in assessing traumatic duodenal injury, primary inflammatory processes and secondary involvement from pancreatitis, developmental abnormalities, infectious processes and duodenal neoplasms [27].
Appropriate endoscopic treatment selection and surveillance for superficial non-ampullary duodenal epithelial tumors
Published in Scandinavian Journal of Gastroenterology, 2021
Kingo Hirasawa, Yuichiro Ozeki, Atsushi Sawada, Chiko Sato, Ryosuke Ikeda, Masafumi Nishio, Takehide Fukuchi, Ryosuke Kobayashi, Makomo Makazu, Masataka Taguri, Shin Maeda
Ninety-eight percent (185/189) of the registered patients received surveillance, followed by endoscopic and tumor marker blood sampling in median periods of 36 months (range 6–132). Among these patients, 5 patients were histologically diagnosed with submucosal invasive cancers after ER (Table 2). One patient underwent an additional pancreatoduodenectomy and was then found to have a lymph node metastasis; the patient subsequently died of the disease. Three patients died, and one had metachronous recurrence of the ileum segment of intestinal cancer during the follow-up. Table 3 shows clinicopathologic characteristics of eight patients with death during the follow-up. Two deaths were attributed to the primary duodenal neoplasms, which invaded the submucosa, while the other patients died of other causes. Thus, the 1-year, 3-year, and 5-year OS were 98.4%, 95.5%, and 92.2%, respectively (Figure 4(A)). Table 4 shows the clinicopathologic characteristics of nine cases with recurrence during the follow-up. Local recurrence occurred in four patients, all of whom underwent an incomplete resection of the mucosal lesions and were treated with repeat ER. Two patients had metastatic recurrence and eventually died of the primary duodenal carcinoma. One patient had secondary advanced carcinoma in the ileum and underwent curative surgery. The remaining two patients had metachronous mucosal duodenal neoplasms. Therefore, the 1-year, 3-year, and 5-year DFS was 97.7%, 91.3%, and 83.5%, respectively (Figure 4(B)).
White light and/or magnifying endoscopy with narrow band imaging for superficial nonampullary duodenal epithelial tumors
Published in Scandinavian Journal of Gastroenterology, 2021
Naomi Kakushima, Masao Yoshida, Kohei Takizawa, Yohei Yabuuchi, Noboru Kawata, Yoshihiro Kishida, Sayo Ito, Kenichiro Imai, Kinichi Hotta, Hirotoshi Ishiwatari, Hiroyuki Matsubayashi, Hiroyuki Ono
Widespread endoscopic screening and surveillance has increased the frequency of detecting duodenal neoplasms including sporadic, superficial non-ampullary epithelial duodenal tumors (SNADET) in Japan and Korea [6–9]. Various endoscopic resection (ER) methods such as cold-snare polypectomy (CSP), endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD) have been developed so far for the treatment of early gastrointestinal tumors including SNADETs [10–16]. Ideally, treatment selection should be considered based on the malignant potential of the lesion, together with the efficacy and safety of the treatment. Low-grade adenomas are indolent tumors and could be followed up [5], or could be treated by a less invasive resection method such as CSP [12]. On the other hand, high-grade adenomas and carcinomas should be treated with a method that could achieve complete removal [5,8,11]. However, there have been no standards for the selection of appropriate endoscopic resection method for SNADETs, and the selection of treatment has been left to the discretion of the attending physician [5,8].
Magnified endoscopy with narrow-band imaging for the differential diagnosis of superficial non-ampullary duodenal epithelial tumors
Published in Scandinavian Journal of Gastroenterology, 2018
Naomi Kakushima, Masao Yoshida, Yuichiro Yamaguchi, Kohei Takizawa, Noboru Kawata, Masaki Tanaka, Yoshihiro Kishida, Sayo Ito, Kenichiro Imai, Kinichi Hotta, Hirotoshi Ishiwatari, Hiroyuki Matsubayashi, Keiko Sasaki, Hiroyuki Ono
Diagnosis and treatment of superficial non-ampullary duodenal epithelial tumors (SNADETs) have increased lately [1–3]. Endoscopic diagnoses of neoplastic lesions in the duodenum are sometimes difficult due to the rarity of duodenal neoplasms and the occurrence of various benign diseases. Regarding the management of SNADETs, one follow-up study has reported that although lesions with a biopsy-based diagnosis of low-grade adenoma (Vienna category 3, [C3]) could be followed up, lesions diagnosed as high-grade adenoma (Vienna category 4, [C4]) should be considered for resection [4]. On the other hand, considering that many duodenal adenomas may follow the adenoma-carcinoma sequence [5], it is reasonable to endoscopically resect SNADETs before they progress to have a higher malignant potential. However, endoscopic resection (ER) has a risk of bleeding and perforation, and the selection of resection such as endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) should be carefully judged according to the characteristics of the lesion [1]. Less invasive ER methods such as cold forceps polypectomy or cold snare polypectomy (CSP) are rapid and convenient, however complete removal of the muscularis mucosa is difficult or insufficient in most cases [6,7]. Tumors that occupy the whole layer or invade beyond the mucosa such as C4 or carcinoma (Vienna category 5, [C5]) should be resected under the muscularis mucosa. In this sense, EMR or ESD is recommended for C4/5 lesions. Therefore, the differential diagnosis between C3 and C4/5 is important to consider treatment management.
Related Knowledge Centers
- Adenocarcinoma
- Colorectal Cancer
- Duodenal Cancer
- Ileum
- Stomach Cancer
- Jejunum
- Duodenum
- Five-Year Survival Rate
- Adenoma
- Ampulla of Vater