Primary tumors of the small bowel: diagnosis, treatment and prognostic factors.

Background/aims: The neoplasms of the small intestine are rare and the preoperative diagnosis is difficult. The aim of this study is to review difficulties in diagnosis, treatment options and important prognostic factors.

Methodology: Fifteen patients who underwent surgical resection for intestinal tumors from 1990 to 2000 in the Third Surgical Clinic of Izmir Atatürk Training and Research Hospital were reviewed retrospectively. Age, symptoms, diagnostic methods, operative procedures, and their effects on prognosis were evaluated.

Results: Seven patients were male and eight were female. The mean age was 52.3 years (27-77). Eight patients underwent urgent intervention and seven had elective surgery. Three cases were diagnosed as small bowel tumor preoperatively. The radical resection of the small bowel neoplasm was possible in 12 patients (80%), eight of whom being malignant and four of whom being leiomyoma. Three patients with leiomyoma are still alive for 3.5, 6 and 9 years but one patient died perioperatively because of respiratory distress syndrome. Two cases with lymphoma survived for 16 and 37 months while another two have been still alive for 7 and 8 years. The patients who had malignant epithelial tumor, leiomyosarcoma, and malignant mesenchymal tumor survived for 17, 54, and 20 months, respectively. The patient with malignant tumor of endocrine origin has still been living for 3 years.

Conclusions: As a result we concluded that better evaluation of signs and symptoms may facilitate the diagnosis; and the most important prognostic factors are early diagnosis and radical surgery.