Current Advance in Small Bowel Tumors

Abstract

Small intestinal tumors are difficult challenge to gastroenterologists. The difficulty in making a diagnosis of small intestinal tumor lies in the relative inaccessibility and absence of typical presentation. New endoscopic and radiologic technologies provide clear and fine anatomical visualization of the small bowel and are approved to improve the diagnostic sensitivity and accuracy. Patients at risk of small intestinal tumors might gain a benefit from proper surveillance with this new technology. Minimally invasive therapy is now available with advance of balloon assisted enteroscopy. This review describes the general aspect of the small intestinal tumors, focusing on the new modalities for diagnosis.

Genetic risks and familial associations of small bowel carcinoma

“…Compared to sporadic SBA in general population, patients with LS present a decade earlier. About 10% of patients develop cancers before the age of 30 [27] . The lifetime risk for SBA is estimated as 1%-4% and is greater than 100 fold risk compared to general population [13,14,28] .…”

Impact of Nodal Staging for Small Bowel Carcinoid: More is Better!

“…The utilization of double contrast method of enteroclysis has increased the detection sensitivity to almost 90%; however, it is only used in 50 to 60% patients being evaluated for SB pathology due to limitations such as lack of visualization of a luminal lesion and the need for a highly-skilled radiologist. 23 CT enteroclysis (CTE) has become a superior modality for the evaluation of SBC because it allows the exploration of the entire SB as well as extraintestinal involvement. CTE can detect SBC that are only 5 mm in size with a negative and positive predictive value for SBC of 100 and 94.7% respectively.…”

Evaluation and management of small-bowel tumors in the era of deep enteroscopy

“…[9][10][11][12][13] Unfortunately, when overt symptoms are present, there may be local invasion or metastases of the tumor, portending a poor prognosis. 3 …”

“…Now, with the development of video capsule endoscopy, as well as deep enteroscopy, that is, balloon-assisted enteroscopy and spiral enteroscopy (SE), the reported incidence of small-bowel tumors has increased. This was reflected in a 2012 Korean study 3 in which the incidence of small-bowel tumors evaluated by capsule endoscopy (CE) had risen to 4.3%; another study 4 identified small-bowel tumors in 8.9% of patients. These studies suggest that the incidence of small-bowel tumors may be higher than previously thought.…”