Evaluation and management of small-bowel tumors in the era of deep enteroscopy

Islam, Rafiul; Leighton, Jonathan A.

doi:10.1016/j.gie.2013.11.003

Cited by 34 publications

(41 citation statements)

References 96 publications

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“…The most common malignancy lesions are adenocarcinoma, neuroendocrine tumor (NET), sarcomas, and small bowel lymphoma. However, the incidence of small bowel cancer is increasing, particularly for carcinoid tumor (Islam, 2014). The small bowel is not a common location of metastatic cancers, although there are many case reports Based on radiology and endoscopy, this study revealed upper gastrointestinal bleeding, an intra-abdominal mass, and a sub-epithelial mass as common symptoms of GIST.…”

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confidence: 70%

“…Upper gastrointestinal study with small bowel followthrough, ultrasonography of the whole abdomen, computed tomography (CT) scan, CT and enteroclysis/ enterography, video capsule enteroscopy (VCE), esophagogastroduodenoscopy (EGD), and balloonassisted enteroscopy (BAE) were commonly used to determine localization of the tumor and to evaluate adjacent organs (Islam et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

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Clinical, Radiologic, and Endoscopic Manifestations of Small Bowel Malignancies: a First Report from Thailand

Tangkittikasem

Boonyaarunnate²,

Aswakul³

et al. 2016

Asian Pacific Journal of Cancer Prevention

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Asian Pac J Cancer Prev, 16 (18), 8613-8618 IntroductionSmall bowel cancer is a rare malignancy that accounts for only 2% of all gastrointestinal cancers (Paski, 2009;Pan et al, 2011). The incidence of malignant small intestine tumors, which ranges from 0.5-1.5/100,000 in men and 0.2-1.0/100,000 in women (Parkin et al., 1992), seems to be higher in North America and Europe than Asia (Haselkorn et al., 2005). Most cases of small bowel cancer are diagnosed late in the course of the disease because of its vague clinical presentations (e.g. abdominal pain and abdominal discomfort), and patients who present with obvious clinical manifestations such as gastrointestinal bleeding, intestinal obstruction, or ascites are almost always diagnosed with advanced stage cancer. The most common malignancy lesions are adenocarcinoma, neuroendocrine tumor (NET), sarcomas, and small bowel lymphoma. However, the incidence of small bowel cancer is increasing, particularly for carcinoid tumor (Islam, 2014). The small bowel is not a common location of metastatic cancers, although there are many case reports Based on radiology and endoscopy, this study revealed upper gastrointestinal bleeding, an intra-abdominal mass, and a sub-epithelial mass as common symptoms of GIST. Obstruction and ulcerating/circumferential masses were findicative of adenocarcinoma, as revealed by radiology and endoscopy, respectively. Finally, no specific symptoms were related to lymphoma.

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mentioning

confidence: 70%

Section: Introductionmentioning

confidence: 99%

Clinical, Radiologic, and Endoscopic Manifestations of Small Bowel Malignancies: a First Report from Thailand

Tangkittikasem

Boonyaarunnate²,

Aswakul³

et al. 2016

Asian Pacific Journal of Cancer Prevention

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“…27 The prevalence of small bowel tumors in patients with OGIB has been reported to range between 5% and 10%, 28,29 malignant tumors accounting for 60% to 75% of cases. 27 In a large multicenter study, 29 the main primary small bowel tumor type was gastrointestinal stromal tumor (GIST) (32%), followed by adenocarcinoma (20%) and carcinoid tumor (15%) (Fig. 2); two thirds of metastatic tumors in the small bowel corresponded to melanomas.…”

Section: Small Bowel Tumors and Polyposis Syndromesmentioning

confidence: 99%

“…Nonetheless, in clinical practice, the tumor is often diagnosed by SBCE in the first place, in patients being investigated for OGIB; subsequently, patients will often undergo crosssectional imaging for staging and eventually proceed to BAE to obtain biopsies for histopathologic diagnosis; BAE may also be used to remove retained capsules proximal to the tumor, as the risk of capsule retention has been reported to be high in this population, ranging from 1.4% to 17%. 27 From a practical point of view, if there is a suspicion of small bowel tumor based on previous cross-sectional imaging studies, BAE could be preferred over SBCE, in order to avoid the risk of capsule retention and to allow biopsies for histopathologic diagnosis. The diagnostic yield of DBE has been shown to be similar to the combination of CTE and SBCE, 33 and the specificity is higher, mainly due to the high rate of false positive submucosal masses detected by SBCE.…”

Section: Small Bowel Tumors and Polyposis Syndromesmentioning

confidence: 99%

Current Clinical Indications for Small Bowel Capsule Endoscopy

Rosa

Cotter

2015

Acta Med Port

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RESUMOIntrodução: A enteroscopia por cápsula é o exame de primeira linha no diagnóstico de diversas patologias do intestino delgado. Este artigo tem por objectivo rever e analisar criticamente as indicações actuais para enteroscopia por cápsula na prática clínica. Material e Métodos: Revisão bibliográfica suportada em artigos indexados na PubMed. Resultados e Discussão: A enteroscopia por cápsula permite a avaliação não invasiva da mucosa do intestino delgado, com elevado rendimento diagnóstico. Em doentes com hemorragia digestiva de causa obscura, o rendimento da enteroscopia por cápsula aumenta quando realizada precocemente após o evento hemorrágico. O tratamento das angiectasias com enteroscopia assistida por balão permite diminuir a recidiva hemorrágica, enquanto o risco de recidiva em doentes com enteroscopia por cápsula "negativa" é controverso. A entero-TC/entero-RM podem superiorizar-se à enteroscopia por cápsula no diagnóstico de alguns tumores. O 'Smooth Protruding Index on Capsule Endoscopy' (score SPICE) auxilia na diferenciação entre verdadeiros tumores submucosos e abaulamentos não patológicos. A enteroscopia por cápsula é valiosa em doentes com suspeita de doença de Crohn quando a ileocolonoscopia não é diagnóstica, permitindo também estadiar a extensão e actividade das lesões em doentes com diagnóstico prévio de doença de Crohn, com potenciais implicações prognósticas e terapêuticas. A enteroscopia por cápsula permite ainda o diagnóstico de complicações em doentes com doença celíaca refractária. Conclusões: Actualmente, a importância da enteroscopia por cápsula é reconhecida no contexto da hemorragia digestiva de causa obscura e/ou suspeita de tumores do intestino delgado, bem como na suspeita de doença de Crohn ou em doentes com doença de Crohn conhecida para determinar a localização, extensão e actividade da doença, e ainda para a investigação de doentes com doença celíaca refractária. Palavras-chave: Doenças Intestinais; Endoscopia por Cápsula. ABSTRACT Introduction:Small bowel capsule endoscopy is currently the first line diagnostic examination for many diseases affecting the small bowel. This article aims to review and critically address the current indications of small bowel capsule endoscopy in clinical practice. Material and Methods: Bibliographic review of relevant and recent papers indexed in PubMed.

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“…3 The diagnosis of small bowel tumor is really challenging even in the modern medicine when novel approaches such as video capsule endoscopy and nuclear magnetic resonance (NMR) are available. [5][6][7][8][9][10][11][12] Here, we report the diagnosis of small bowel cancer with NMR in a patient presenting with intestine sub-occlusion.…”

Section: Introductionmentioning

confidence: 99%

Small bowel cancer diagnosis: role of nuclear magnetic resonance

et al. 2015

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Small intestine tumors are rare, with an incidence of less than 1 case per 100,000/year and accounting for less than 0.5% of all cancers.1 However, in almost 80% of the cases small bowel tumors are malignant.2,3 Adenocarcinomas comprise 35-50% of all tumors, carcinoid tumors 20-40%, lymphomas 15% and the remaining is characterized by sarcomas. 4 Generally, adenocarcinomas are located in the duodenum, while lymphomas and carcinoid tumors are frequently in the ileum. Benign tumors are generally stromal tumor and adenomas. Finally, cancers from other organs may infiltrate peritoneum and small bowel in metastatic diseases. Small bowel tumors did not have a recurrent clinical presentation and could be associated with abdominal pain, unspecific gastrointestinal symptoms or can exhibit symptoms/signs due to the secretion of different hormones. 3 The diagnosis of small bowel tumor is really challenging even in the modern medicine when novel approaches such as video capsule endoscopy and nuclear magnetic resonance (NMR) are available.5-12 Here, we report the diagnosis of small bowel cancer with NMR in a patient presenting with intestine sub-occlusion. Case ReportA male patient was admitted to our division of Internal Medicine because of abdominal pain, weight loss and intestinal sub-occlusion. Both abdomen echography and computed tomography-scan (data not shown) did not reveal any significant pathological signs. Due to the persistence of the symptoms, an abdomen NMR was performed. As shown in Figure 1A and B, NMR revealed that a portion of the small bowel was characterized by the swelling of the bowel wall. A laparoscopic surgical evaluation was performed confirming the presence of small bowel stenosis. This small intestine segment was therefore surgical removed. At the pathological examination, this portion of the bowel revealed an infiltration of the wall by an adenocarcinoma ( Figure 1C). Moreover, infiltration of the peritoneum was also observed ( Figure 1D). Small bowel cancer diagnosis: role of nuclear magnetic resonance ABSTRACTThe diagnosis of small intestine tumors is challenging. Even in the era of modern medicine, standard approaches including echography, computed tomography-scan and conventional endoscopy are unable to reveal small bowel lesions. Video-capsule has substantially improved the evaluation of small bowel; however this procedure cannot be proposed to all patients and in particular to those experiencing intestine sub-occlusion. Nuclear magnetic resonance (NMR) of the abdomen is an additional diagnostic approach that offers high sensitivity in the identification of small bowel lesions. Here, we describe a case of small bowel neoplasia identified with NMR of the abdomen.

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Evaluation and management of small-bowel tumors in the era of deep enteroscopy

Cited by 34 publications

References 96 publications

Clinical, Radiologic, and Endoscopic Manifestations of Small Bowel Malignancies: a First Report from Thailand

Clinical, Radiologic, and Endoscopic Manifestations of Small Bowel Malignancies: a First Report from Thailand

Current Clinical Indications for Small Bowel Capsule Endoscopy

Small bowel cancer diagnosis: role of nuclear magnetic resonance

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