Tumors of the Small Intestine

Abstract

This collective review includes all available case reports and series of smooth muscle (stromal) tumors of the small intestine in the world literature from 1881 to 1996. We identified 1074 patients with leiomyoma (LM) and 1689 with leiomyosarcoma (LMS). Our purpose was to update our previous review, which encompassed case reports and series from 1881 to 1959, which included 350 LMs and 257 LMSs. The peak incidence of smooth muscle tumors in the small intestine in both male and female patients was between the ages of 50 and 59. Most commonly, the presenting complaint was gastrointestinal bleeding. Computed tomography was found to detect LM and LMS most successfully and had the additional advantage of locating metastatic disease. The jejunum contained the highest numbers of smooth muscle tumors, followed by the ileum and then the duodenum, with malignant lesions in all locations typically attaining larger diameters than benign tumors. The overall rate of metastatic spread of LMS ranged from 24% to 50%, with the liver being most commonly involved. Unlike other sarcomas, both hematogenous and lymphatic spread were common. The 5-year survival of 705 patients with LMS from 22 series was 27. 8%. For both benign and malignant smooth muscle tumors of the small intestine, surgery remains the treatment of choice, with little efficacy reported for irradiation, chemotherapy, or both.

Small bowel leiomyosarcoma: A case report and literature review

“…The location of the tumor, duration of symptoms, and age of the patient were not predictors for metastasis, but metastasis was more likely with a tumor size larger than 5 cm (8). LMS appeared to metastasize hematogenously, especially to the liver (65% of metastases), other GI locations (15%), and the lungs (4%).…”

“…Preoperative diagnosis of small intestine tumors remains very difficult, especially differentiating between benign and malignant tumors (8). Several radiological methods have been proposed in imaging tumors of the small intestine.…”

“…Furthermore, LMSs have a very low response rate to chemotherapy (23,24). Therefore, metastasectomy, if possible, should be considered (5,8,25). In the case of hepatic LMS metastases, primary and repeated metastasectomy combined with the resection of extrahepatic metastases showed better survival than chemotherapy (26).…”

Small Intestinal Metastasis from Small Cell Lung Cancer

“…Small bowel follow-through may show a mass lesion, mucosal defect, or intussusception, but it is often unremarkable, and has a sensitivity of 33% for detection of malignant small intestinal tumors (16). In contrast, an abdominal CT scan with intravenous and oral contrast has a sensitivity of 87% for identifying the manifestations of carcinoid tumor in the small intestine (17 (19,20 …”

Rectus abdominalis muscle metastasis from uterine leiomyosarcoma: An unusual case and review of the literature

“…Leiomyosarcomas are malignant tumors of smooth muscle, and it constitutes 5% of soft tissue sarcomas (1,2). It is diagnosed in 1.3% of all uterine malignancies (3).…”