| Theme | Gastrointesinal Submucosal Tumor -- Advances in the Diagnosis and Treatment | |
|---|---|---|
| Title | Submucosal Tumors of the Duodenum and Small Intestine -- Epidemiology, Diagnosis and Treatment | |
| Publish Date | 2001/03 | |
| Author | Keisuke Honda | Division of Gastroenterology, Department of Medicine, Kawasaki Medical School |
| Author | Mitsuo Iida | Division of Gastroenterology, Department of Medicine, Kawasaki Medical School |
| [ Summary ] | Submucosal tumors (SMT) of the duodenum, jejunum, and ileum (small intestine) were analyzed, in Japan, over the past 5 years (1995～1999). The most common type of benign lesions were leiomyoma and lipoma. The most common malignant lesions were malignant lymphoma and leiomyosarcoma. Brunner's gland adenoma and carcinoid tumors were more common in the duodenum. There was no difference in patient age between types of SMT. Chief complaints with SMT were abdominal pain, hemorrhaging, anemia and abdominal masses. Abdominal pain was the most common intial symptom for malignant lymphoma. Hemorrhaging and anemia were frequent in myogenic tumors. Abdominal masses (consisting of tumors or distended bowels or both) were palpable in cases of malignant SMT. However, the majority of SMT were asymptomatic in the early stages. Small bowel SMT should be considered as one of the less frequent causes in differential diagnoses of unexplained abdominal pain, chronic anemia, and/or occult gastrointestinal (CI) bleeding. Barium studies were the first diagnostic modality for SMT of the small intestine. Endoscopy and non-ivasive modalities also played important roles. Further investigation after barium studies depends on what kind of tumor is suspected. CT was useful in detecting tumor-specific appearance, invasion of adjacent organs and metastatic lesions. MRI was less useful than CT. Although angiography is not routinely performed on patients with suspected SMT, it is often indicated if the cause of GI bleeding is not revealed by barium studies or endoscopy. All SMT that are causing bowel symptoms should be treated. Depending on the size and nature of SMT, endoscopic resection may be selected. Further easy, non-invasive therapeutic modalities are recommended. |
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