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PubMed2004

[Surgical complications for gastric and small bowel metastases due to primary lung carcinoma].

Lung carcinoma is the first cause of death for tumors; in Italy there are from 35,000 to 40,000 new cases a year, with a global survival to 5 years from the diagnosis in 13% of cases. The gastric and small bowel metastases are rare, respectively 0.4% and 1.1% and the cases reported in the literature are rare. There is often a poor symptomatology and diagnosis is usually based on post-mortem examination. Yet, sometimes, the first and only demonstration of the secondary illness is a surgical complication, whether it be a haemorrhage, a perforation or an occlusion. The authors report their experience, from April 1999 to March 2003, of 3 cases of small bowel metastases, presented in 1 case with a perforation and in 2 cases with an occlusion and of 1 case of gastric metastasis, which presented with a haemorrhage. These patients were treated by emergency surgery, with 1 case only of postoperative mortality. The 1st patient died 6 months after surgery, and the 2nd patient 6 days after, the 3rd patient 4 months after the 1st operation and the 4th patient is still in follow-up after 6 months. The authors present a review of the literature and some considerations of diagnosis and surgical treatment.

Adenocarcinoma↗
PubMed1977

Arteriography in malignant neoplasms of the bowel.

Eighty patients with gastrointestinal bleeding were investigated by angiography over a four-year period. Nine had malignant neoplasms of the bowel. Inconspicuous neovascularity was the most constant finding, best seen in leiomyosarcoma of the small bowel and adenocarcinoma of the colon. Neovascularity was not seen in a patient with reticulum cell sarcoma of colon detected by extravasation. When other studies including endoscopy and barium examinations have failed to explain acute or chronic bleeding, an appreciable number of intestinal neoplasms may be demonstrated by arteriography.

Adenocarcinoma↗
PubMed1994

Small bowel cancer: epidemiological and clinical characteristics from a population-based registry.

OBJECTIVES: Data on small bowel cancers are scarce, and are derived primarily from hospital series. Our aim was to examine the epidemiological and clinical characteristics of these rare cancers. The database is population-based registry with complete ascertainment. It is thus free of the selection bias innate to hospital series. METHODS: Review of the Utah Cancer Registry for all small bowel cancers from 1966 through 1990. For comparison, other cancers were reviewed for incidence and relative survival rates. RESULTS: There were 328 small bowel cancers, including 136 (41%) carcinoids, 80 (24%) adenocarcinomas, 72 (22%) lymphomas, 36 (11%) sarcomas, and four (1%) unclassified. The overall age-adjusted incidence per 100,000 was 1.4 for small bowel cancers compared to 35.7 for colorectum and 92.9 for breast. Small bowel cancers occurred most frequently in the sixth and seventh decades of life, and were more common in men. Carcinoids, lymphomas, and sarcomas occurred in order of decreasing frequently in the ileum, jejunum, and duodenum; the reverse was true for adenocarcinomas. Distant metastases occurred in 35 (27%) carcinoids, 14 (28%) adenocarcinomas, 17 (26%) lymphomas, and 10 (33%) sarcomas. Surgery was the primary form of therapy in 108 (79%) carcinoid patients, 80 (49%) adenocarcinoma patients, 52 (72%) lymphoma patients, and 26 (72%) sarcoma patients. The overall 5-year relative survival rate for small bowel cancers was 54%; 83% for carcinoids, 25% for adenocarcinomas, 62% for lymphomas, and 45% for sarcomas. Overall survival, compared to other cancer sites, was surpassed only by cancers of the prostate, breast, and colorectum. CONCLUSIONS: Small bowel cancers consist of several types of rare tumors, each with unique characteristics. The overall prognosis is better than for most common cancers.

Adenocarcinoma↗