Association of Primary Neoplasms of the Small Intestine with Other Neoplastic Growths

Abstract

THE COMPLICATIONS of primary tumors of the small intestine usually considered to be of surgical significance are related to their growth and metastasis. These include intestinal obstruction, intussusception, hemorrhage, and perforation. In addition, other complications may develop from the effects of metabolic products of certain tumors, particularly the carcinoids.Recently another interesting characteristic of small bowel tumors has been noted, their association with an increased incidence of concurrent neoplasms in other parts of the body. To study this association, a review of all of the autopsy material at the Cincinnati General Hospital over a 15 year period has been made. This incidence of concurrent neoplastic growths was studied in patients with primary neoplasms of the small intestine and compared with that found in patients in the general autopsy population with allowances being made for age. The results of this study indicate that individuals with primary neoplasms of the small intestine are particularly prone to develop primary neoplasms elsewhere.

Small-Bowel Tumors

“…In a large study of 9721 consecutive autopsies, 112 neoplasms of the small bowel were discovered, 72 of which were benign lesions (64.3%). 22 This suggests that the prevalence of asymptomatic lesions may be even higher than reported herein. Histologically, in the present study, carcinoid tumors were the predominant form of small-bowel neoplasms (417 cases; 33%), followed by adenocarcinomas (379 cases; 30.1%).…”

Small Bowel Tumors: An Overview

“…The transit time through the small bowel is much faster than that through the colon, thereby reducing the time that the small bowel is exposed to any potential car cinogens [6], The contents of the small bowel are liquid and may be less irritating to the mucosa. In addition, the contents oflhe small bowel are at a neutral or alkaline pH and also contain a high level of benzopyrene hydroxy lases, which may inhibit carcinogens [7], Fur thermore the small bowel is rich in lymphoid tissue with a high level of surface IgA expres sion, and this may be protective whereas the increase in frequency of small bowel tumors in Crohn's disease may indicate a decrease in the surveillance capability of the small bowel [8], It has also been noted that patients with small bowel malignancies experience a higher incidence of tumors at other sites, reinforcing the theory of the immunoprotective role of the small bowel [9], The bacterial flora of the small bowel are also quite different from those of the colon, with far fewer anaerobes and far lower total counts; bacterial degradation of bile salts to carcinogenic metabolites in the colon is often postulated as a source of colonic carcinogene sis. Immunoproliferative small intestinal dis ease, also known as Mediterranean lympho ma or a-chain disease, is a condition found in the Middle East and is associated with chronic enteric infection by parasites, poor sanitation, and low socioeconomic status [ 10].…”

The risk of metachronous cancers in patients with small-intestinal carcinoid tumors: a US population-based study

“…With regard to SICs, metachronous cancers may be a consequence of bioactive, potentially neoplasiapromoting secretory products affecting a variety of cell types (Modlin et al 2003). Earlier studies investigating the incidence of additional primary cancers among patients with neuroendocrine tumors (NETs) have been either autopsy studies or limited by small sample sizes (Alexander & Altemeier 1968, Gerstle et al 1995, Habal et al 2000. As such, they have focused on gastrointestinal NETs in general, as opposed to more specifically SIC tumors.…”