Small intestine cancer
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Qurrat-ul-ain Abid, M.D.[2], Parminder Dhingra, M.D. [3]
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Small intestine cancer Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Small intestine cancer On the Web |
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American Roentgen Ray Society Images of Small intestine cancer |
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Risk calculators and risk factors for Small intestine cancer |
Synonyms and keywords:
Overview
Historical Perspective
[Disease name] was first discovered by [name of scientist], a [nationality + occupation], in [year]/during/following [event].
The association between [important risk factor/cause] and [disease name] was made in/during [year/event].
In [year], [scientist] was the first to discover the association between [risk factor] and the development of [disease name].
In [year], [gene] mutations were first implicated in the pathogenesis of [disease name].
There have been several outbreaks of [disease name], including -----.
In [year], [diagnostic test/therapy] was developed by [scientist] to treat/diagnose [disease name].
Classification
Intestinal cancers can be classified into benign tumors, malignant tumors and extra-intestinal tumors. Benign tumors are: leiomyoma, lipoma, hamartoma and desmoid tumors. Malignant tumors of small intestine are: adenocarcinoma, leiomyosarcoma, carcinoid, and lymphomas. Extra-intestinal tumors metastasize to small intestine mostly through contagious spread or through peritoneal implantation. Metastatic spread through blood supply is very uncommon and is route of spread for Melanoma.[1]
Pathophysiology
Ptahophysiology of small intestinal cancers is not much studied domain as it is a rare condition. However the incidence has increased recently particularly in black males and it stays same for the females. There is no explanation yet for the increase in the incidence. Studies are being conducted to evaluate association with environmental risk factors. [2] Cancer of small intestine can arise sporadically or they are associated with genetic diseases. Familial adenomatous polyposis coli, Peutz-Jeghers syndrome and chronic intestinal inflammatory disorders e.g., Crohn's disease or Celiac sprue are some of the associations of small intestinal tumors.[1] Adenocarcinomas and Carcinoid tumors of the smalls intestine are associated with malignant tumors of the other sites. Rarely people with Peutz-Jeghers syndrome can develop malignant changes in polyps present in small intestine.[3] Primary adenocarcinoma consists of 40% of cases of malignant tumors of small intestine and it is the most common histologic type. Carcinoid tumor is the second most common cancer of the small bowel.
Duodenal tumors are more common than the tumors of jejunum and illeum.[4]
It is thought that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].
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[Pathogen name] is usually transmitted via the [transmission route] route to the human host.
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Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.
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[Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].
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The progression to [disease name] usually involves the [molecular pathway].
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The pathophysiology of [disease/malignancy] depends on the histological subtype.
Causes
Disease name] may be caused by [cause1], [cause2], or [cause3].
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Common causes of [disease] include [cause1], [cause2], and [cause3].
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The most common cause of [disease name] is [cause 1]. Less common causes of [disease name] include [cause 2], [cause 3], and [cause 4].
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The cause of [disease name] has not been identified. To review risk factors for the development of [disease name], click here.
Epidemiology and Demographics
Small intestinal cancer makes less than two percent of the gastrointestinal track cancers.[5]
The incidence/prevalence of [disease name] is approximately [number range] per 100,000 individuals worldwide.
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In [year], the incidence/prevalence of [disease name] was estimated to be [number range] cases per 100,000 individuals worldwide.
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In [year], the incidence of [disease name] is approximately [number range] per 100,000 individuals with a case-fatality rate of [number range]%.
Patients of all age groups may develop [disease name].
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The incidence of [disease name] increases with age; the median age at diagnosis is [#] years.
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[Disease name] commonly affects individuals younger than/older than [number of years] years of age.
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[Chronic disease name] is usually first diagnosed among [age group].
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[Acute disease name] commonly affects [age group].
There is no racial predilection to [disease name].
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[Disease name] usually affects individuals of the [race 1] race. [Race 2] individuals are less likely to develop [disease name].
[Disease name] affects men and women equally.
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[Gender 1] are more commonly affected by [disease name] than [gender 2]. The [gender 1] to [gender 2] ratio is approximately [number > 1] to 1.
The majority of [disease name] cases are reported in [geographical region].
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[Disease name] is a common/rare disease that tends to affect [patient population 1] and [patient population 2].
Risk Factors
There are no established risk factor. Crohn disease is considered to be the most important risk factor of small intestinal cancers.[4]
Screening
Currently there are no screening protocols and rarity of condition makes it a less suspected condition.[6]
Natural History, Complications, and Prognosis
Adenocarcinoma of the duodenum is associated with low overall survival rate compared to the tumors located in Jejunum and ileum.[4]
If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
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Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
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Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
Diagnosis
Adenocarcinoma of the small intestine is usually diagnosed late and patients present with metastasis of lymph node or distant sites. Main stay of the treatment is surgery for these tumors. [7]. Small intestinal cancers are not suspected clinically as their incidence is very low. Inaccessibility of endoscope to the small intestine can be cause of its late diagnosis. Small intestinal tumors can be diagnosed using enteroscope.[6]
History and Symptoms
The majority of patients with [disease name] are asymptomatic.
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The hallmark of [disease name] is [finding]. A positive history of [finding 1] and [finding 2] is suggestive of [disease name]. The most common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3]. Common symptoms of [disease] include [symptom 1], [symptom 2], and [symptom 3]. Less common symptoms of [disease name] include [symptom 1], [symptom 2], and [symptom 3].
Physical Examination
Patients with [disease name] usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].
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Common physical examination findings of [disease name] include [finding 1], [finding 2], and [finding 3].
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The presence of [finding(s)] on physical examination is diagnostic of [disease name].
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The presence of [finding(s)] on physical examination is highly suggestive of [disease name].
CT scan
There are no CT scan findings associated with [disease name].
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[Location] CT scan may be helpful in the diagnosis of [disease name]. Findings on CT scan suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
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There are no CT scan findings associated with [disease name]. However, a CT scan may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
MRI
There are no MRI findings associated with [disease name].
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[Location] MRI may be helpful in the diagnosis of [disease name]. Findings on MRI suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
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There are no MRI findings associated with [disease name]. However, a MRI may be helpful in the diagnosis of complications of [disease name], which include [complication 1], [complication 2], and [complication 3].
Other Imaging Findings
There are no other imaging findings associated with [disease name].
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[Imaging modality] may be helpful in the diagnosis of [disease name]. Findings on an [imaging modality] suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
Other Diagnostic Studies
There are no other diagnostic studies associated with [disease name].
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[Diagnostic study] may be helpful in the diagnosis of [disease name]. Findings suggestive of/diagnostic of [disease name] include [finding 1], [finding 2], and [finding 3].
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Other diagnostic studies for [disease name] include [diagnostic study 1], which demonstrates [finding 1], [finding 2], and [finding 3], and [diagnostic study 2], which demonstrates [finding 1], [finding 2], and [finding 3].
Treatment
For non-metastatic disease curative surgery gives good results when done in a tertiary care center. Adenocarcinoma of duodenum has a low 5-year disease free survival rate and requires surgery.[4] The role of adjuvant chemotherapy for small intestinal cancer is not established yet.[8]
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Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either [indication 1], [indication 2], and [indication 3]
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The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either [indication 1], [indication 2], and/or [indication 3].
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The feasibility of surgery depends on the stage of [malignancy] at diagnosis.
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Surgery is the mainstay of treatment for [disease or malignancy].
Primary Prevention
There are no established measures for the primary prevention of [disease name].
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There are no available vaccines against [disease name].
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Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].
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[Vaccine name] vaccine is recommended for [patient population] to prevent [disease name]. Other primary prevention strategies include [strategy 1], [strategy 2], and [strategy 3].
Secondary Prevention
There are no established measures for the secondary prevention of [disease name].
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Effective measures for the secondary prevention of [disease name] include [strategy 1], [strategy 2], and [strategy 3].
References
- ↑ 1.0 1.1 Gill SS, Heuman DM, Mihas AA (October 2001). "Small intestinal neoplasms". J. Clin. Gastroenterol. 33 (4): 267–82. PMID 11588539.
- ↑ Severson RK, Schenk M, Gurney JG, Weiss LK, Demers RY (February 1996). "Increasing incidence of adenocarcinomas and carcinoid tumors of the small intestine in adults". Cancer Epidemiol. Biomarkers Prev. 5 (2): 81–4. PMID 8850266.
- ↑ Barclay TH, Schapira DV (March 1983). "Malignant tumors of the small intestine". Cancer. 51 (5): 878–81. PMID 6821853.
- ↑ 4.0 4.1 4.2 4.3 Dabaja BS, Suki D, Pro B, Bonnen M, Ajani J (August 2004). "Adenocarcinoma of the small bowel: presentation, prognostic factors, and outcome of 217 patients". Cancer. 101 (3): 518–26. doi:10.1002/cncr.20404. PMID 15274064.
- ↑ North JH, Pack MS (January 2000). "Malignant tumors of the small intestine: a review of 144 cases". Am Surg. 66 (1): 46–51. PMID 10651347.
- ↑ 6.0 6.1 Rossini FP, Risio M, Pennazio M (January 1999). "Small bowel tumors and polyposis syndromes". Gastrointest. Endosc. Clin. N. Am. 9 (1): 93–114. PMID 9834319.
- ↑ Ogata Y, Yamaguchi K, Sasatomi T, Uchida S, Akagi Y, Shirouzu K (August 2010). "[Treatment and outcome in small bowel cancer]". Gan To Kagaku Ryoho (in Japanese). 37 (8): 1454–7. PMID 20716869.
- ↑ Overman MJ, Kopetz S, Lin E, Abbruzzese JL, Wolff RA (May 2010). "Is there a role for adjuvant therapy in resected adenocarcinoma of the small intestine". Acta Oncol. 49 (4): 474–9. doi:10.3109/02841860903490051. PMID 20397775.