Small Bowel Neoplasias: Current Options for Diagnosis, Staging and Therapeutic Management

Lucia C. Fry, Juan Pablo Gutierrez, Ivan Jovanovic, Klaus Mönkemüller
2013 Gastrointestinal Tumors  
Key Message New imaging techniques such as capsule endoscopy and balloon-assisted endoscopy have facilitated the early diagnosis of small bowel malignancies, leading to a better understanding of the biology of these tumors and to improved clinical outcomes for the patient. Practical Implications Although relatively rare, the incidence of tumors and polyps in the small intestine has increased over the past 20 years. The use of endoscopic or radiologic techniques is crucial for the detection and
more » ... esection of polyps. It is highly recommended to perform a submucosal injection of epinephrine-saline solution prior to endoscopic resection. Due to their non-specific symptoms, neuroendocrine tumors are often diagnosed in advanced stages; surgical excision of the primary tumor is key to a better prognosis. The main therapies for neuroendocrine tumors are surgery, chemoembolization, chemotherapy and the use of somatostatin analogues. Small bowel adenocarcinomas are extremely rare but can be highly fatal. Surgical resection is still the core treatment, though fluoropyrimidine and oxaliplatin-based chemotherapy have shown beneficial effects for the treatment of metastatic disease. Amongst the gastrointestinal stromal tumors, 30% are located in the small intestine. The management of gastrointestinal stromal tumors requires a combination of surgery, pathology techniques and pharmacological interventions, including the use of tyrosine kinase inhibitors.
doi:10.1159/000355210 fatcat:ebbssmlstzhxdgrwj3h35koxcq