Malignant tumors of the small intestine

Malignant tumors of the small intestine. They are rare. Carcinoid is most often localized in the terminal ileum, has small dimensions, develops slowly. In the absence of serotonin secretion, clinical symptoms are little pronounced (diarrhea, weight loss). With the increase in the tumor, pain in the abdomen and symptoms of partial intestinal obstruction gradually appear. The time from the onset of symptoms to the diagnosis can be several years. Carcinoid syndrome, in addition to diarrhea, is manifested by reddening of the face and trunk, a high urinary content of 5-hydroxyindoleacetic acid. The incidence of carcinoid syndrome is 10-30%. Metastases of malignant carcinoid occur in the abdominal cavity, regional lymph nodes and liver. Sometimes metastases appear after many years. The main method of treatment is surgical. Five-year survival after radical surgery is 90%, 10-year survival is 75%. In the presence of metastases in the abdominal cavity and lymph nodes, 5-year survival is 57%, with metastases in the liver - 31%. Chemotherapy can be effective (stestozotocin - 500 mg / m2 on / in the 1 - 5 days in combination with 5-fluorouracil - 325 mg / m2 on days 1-5).

Adenocarcinoma is localized more often in the duodenum and jejunum. It is manifested by intestinal bleeding, pain, weight loss, rarely diarrhea, fever. Treatment is surgical.

Leiomyosarcoma can reach large sizes, localized in the duodenum and jejunum. It is manifested by pain and intestinal bleeding. Radical surgery cures 40% of patients. In the differential diagnosis of small intestine tumors, one should remember the possibility of developing lymphosarcoma and inflammatory diseases.