PRIMARY MALIGNANT-TUMORS OF THE SMALL-INTESTINE - ANALYSIS OF 40 JAPANESE PATIENTS

Forty Japanese patients with primary malignant tumors of the small intestine were reviewed. Adenocarcinoma was the most common tumor type comprising 19 patients (47%), followed by malignant lymphoma, 11 (30%), leiomyosarcoma, 8 (20%) and carcinoid tumor, 1 (3%). Adenocarcinomas and leiomyosarcomas were primarily located in the duodenum or jejunum, whereas lymphomas were more common in the jejunum or ileum. Abdominal pain (65%) and nausea or vomiting (35%) were the most common symptoms with these tumors. Barium contrast studies were able to detect 83% of these tumors. Our results also suggest that computed tomography and ultrasonography are not reliable for diagnosing jejunal tumors while superior mesenteric angiography is effective for diagnosing ileal tumors. The duodenal and ileal tumors tended to metastasize to lymph nodes while jejunal ones tended to penetrate the serosa or to disseminate into the peritoneal cavity. The percentage of tumors potentially cured by surgery and the 5 year survival rates of the leiomyosarcomas (75% and 57%, respectively) were higher than those of adenocarcinomas (42% and 10%, respectively) and lymphomas (42% and 32%, respectively).