Small Bowel Tumors: Pathology and Management
James Matthew Lloyd Williamson MD*,
Robin Charles Noel Williamson MD**
Affiliation :
* Department of Hepatopancreatobiliary Surgery, Bristol Royal Infirmary, Upper Maudlin Street, Bristol, BS2 8HW, UK
** Department of Hepatopancreatobiliary Surgery, Hammersmith Hospital, London, UK
Despite comprising at least 75% of the length of the gastrointestinal tract, the small bowel only accounts for
3 to 6% of all its neoplasms. Forty different tumor subtypes arise from the small bowel; the commonest is adenoma, and
malignant lesions include gastrointestinal stromal tumor, neuroendocrine tumor, lymphoma, and adenocarcinoma. Small
bowel tumors typically cause either non-specific symptoms or none at all, which explains both the frequent delay in diagnosis
and the wide range of potential investigations. The relative inaccessibility of the small bowel to endoscopic assessment is
being challenged by the increased use of both capsule and double balloon endoscopy. Advances in endoscopic assessment
are mirrored by improved sensitivity of radiological and nuclear imaging. Operative resection provides the mainstay of
treatment for malignant disease (and symptomatic benign lesions), with oncological agents and somatostatin analogues
providing useful adjuncts for inhibiting tumor growth and relieving symptoms. Survival reflects underlying tumor subtype,
but is generally poor for malignant disease.
Keywords : Small bowel tumors, Small bowel cancer, Small bowel lymphoma, Small bowel neuroendocrine tumors
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