Small bowel adenocarcinoma: Epidemiology, risk factors, diagnosis and treatment

Abstract

Small bowel adenocarcinomas are rare tumours, but their incidence is increasing. Their most common primary location is the duodenum. The few studies that have collected data regarding small bowel adenocarcinoma are not homogeneous and are widely spread over time. Even though these tumours are most often sporadic, some predisposing diseases have been identified, among which Crohn's disease and genetic syndromes. Early diagnosis of small bowel adenocarcinoma remains difficult despite significant radiological and endoscopic progress. After surgical resection the main prognostic factor is node invasion; in this case, adjuvant chemotherapy can be expected to be beneficial, although this has not been established by randomised trials. For metastatic disease, platinum-based chemotherapy seems to be the most effective treatment. Targeted therapies have not yet been evaluated in this type of cancer.

Rare Coexistance of Ileal Diverticulosis, Crohn’s Disease and Small Bowel Adenocarcinoma: Report of a Case

“…About 2% of patients affected by CD will develop cancer in the course of their disease, and, in contrast to the patients with ulcerative colitis (UC), those with CD are at risk for developing malignancy even in the first decade of their disease (9). The coexistence of CD with adenocarcinoma is predominantly seen in men, in the patients with excluded loop and most frequently in the distal ileum in an area of active disease (9).…”

“…The coexistence of CD with adenocarcinoma is predominantly seen in men, in the patients with excluded loop and most frequently in the distal ileum in an area of active disease (9). Most patients presenting with adenocarcinoma complicating CD have a high-grade malignancy with lymph node involvement or distant metastases, because the similarity of the presenting symptoms and of the radiography of these pathologies creates diagnostic problems for the physician and make an early diagnosis impossible (1).…”

Small bowel adenocarcinoma (SBA) — a case report

“…The risk factors for SBA include: familial adenomatous polyposis (FAP), Lynch II syndrome (HNPCC, hereditary non--polyposis colorectal cancer), Peutz-Jeghers syndrome, sporadic polyps, Crohn's disease, coeliac disease, AIDS, a history of cholecystectomy, smoking and alcohol consumption [1,2,5,7]. The median age at diagnosis for SBA is 67 years with over 85% of patients presenting after age 50 [1].…”

“…I), [2]. Small bowel adenocarcinoma (SBA) is most commonly located in the duodenum (57%) and jejunum (29%), whereas it is most rarely found in the ileum (10%) [1,4,5], while carcinoid tumour and sarcoma are most commonly found in the ileum [1,2,6].…”

Endoscopic mucosal resection of duodenal bulb adenocarcinoma with neuroendocrine features: An extremely rare case report

“…Duodenal adenocarcinoma accounts for half of all small bowel adenocarcinomas [1][2][3] . Histologically, 40% of small bowel cancer are adenocarcinoma and another 40% are neuroendocrine tumors.…”