Skip to main content
PMC home page
Annals of Surgery logoLink to Annals of Surgery
. 1983 Feb;197(2):172–178. doi: 10.1097/00000658-198302000-00008

Adenocarcinoma and lymphoma of the small intestine. Distribution and etiologic associations.

R C Williamson, C E Welch, R A Malt
PMCID: PMC1353105  PMID: 6337568

Abstract

Malignant small-bowel tumors in 171 patients over 64 years included 68 with adenocarcinomas, 41 with primary lymphomas, 50 with carcinoids, and 12 with sarcomas. The distribution of the carcinomas showed approximately 80% preponderance in the duodenum and proximal jejunum. A similar distribution in the upper small bowel in small-bowel carcinomas induced in Fischer and Sprague-Dawley rats by azoxymethane (90-160 mg/kg) suggests defense mechanisms within ileal mucosa. The clinical series from 1958 to 1976 included two Crohn's carcinomas (jejunum, defunctioned ileum), two jejunal cancers (lymphoma, carcinoma) associated with celiac disease, two duodenal carcinomas arising in villous adenomas, and one jejunal lymphoma following exposure to irradiation. Multiple primary malignancies were found in 20 to 25% of enteric cancers. Hemorrhage was more common with carcinoma than lymphoma, but lymphomas predominated considering perforation or a palpable mass. Both carcinoma and lymphoma had 75 to 80% resectability rates and 14 to 15% five-year postoperative survival rates. The prognosis was least poor for carcinoma of the jejunum, one third of patients with "curative" resections surviving five years.

Full text

PDF
172

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alexander J. W., Altemeier W. A. Association of primary neoplasms of the small intestine with other neoplastic growths. Ann Surg. 1968 Jun;167(6):958–964. doi: 10.1097/00000658-196806000-00017. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Arthaud J. B., Guinee V. F. Jejunal and ileal adenocarcinoma. Epidemiological considerations. Am J Gastroenterol. 1979 Dec;72(6):638–646. [PubMed] [Google Scholar]
  3. Awrich A. E., Irish C. E., Vetto R. M., Fletcher W. S. A twenty-five year experience with primary malignant tumors of the small intestine. Surg Gynecol Obstet. 1980 Jul;151(1):9–14. [PubMed] [Google Scholar]
  4. Bridge M. F., Perzin K. H. Primary adenocarcinoma of the jejunum and ileum. A clinicopathologic study. Cancer. 1975 Nov;36(5):1876–1887. doi: 10.1002/1097-0142(197511)36:5<1876::aid-cncr2820360545>3.0.co;2-7. [DOI] [PubMed] [Google Scholar]
  5. Brookes V. S., Waterhouse J. A., Powell D. J. Malignant lesions of the small intestine: a ten-year survey. Br J Surg. 1968 Jun;55(6):405–410. doi: 10.1002/bjs.1800550602. [DOI] [PubMed] [Google Scholar]
  6. Calman K. C. Why are small bowel tumours rare? An experimental model. Gut. 1974 Jul;15(7):552–554. doi: 10.1136/gut.15.7.552. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Codling B. W., Keighley M. R., Slaney G. Hodgkin's disease complicating Crohn's colitis. Surgery. 1977 Nov;82(5):625–628. [PubMed] [Google Scholar]
  8. Cooper B. T., Holmes G. K., Ferguson R., Cooke W. T. Celiac disease and malignancy. Medicine (Baltimore) 1980 Jul;59(4):249–261. doi: 10.1097/00005792-198007000-00002. [DOI] [PubMed] [Google Scholar]
  9. Craft C. F., Mendelsohn G., Cooper H. S., Yardley J. H. Colonic "precancer" in Crohn's disease. Gastroenterology. 1981 Mar;80(3):578–584. [PubMed] [Google Scholar]
  10. DARLING R. C., WELCH C. E. Tumors of the small intestine. N Engl J Med. 1959 Feb 26;260(9):397–408. doi: 10.1056/NEJM195902262600901. [DOI] [PubMed] [Google Scholar]
  11. Dorman J. E., Floyd C. E., Cohn I., Jr Malignant neoplasms of the small bowel. Am J Surg. 1967 Jan;113(1):131–136. doi: 10.1016/0002-9610(67)90266-8. [DOI] [PubMed] [Google Scholar]
  12. Fresko D., Lazarus S. S., Dotan J., Reingold M. Early presentation of carcinoma of the small bowel in Crohn's disease ("Crohn's carcinoma"). Case reports and review of the literature. Gastroenterology. 1982 Apr;82(4):783–789. [PubMed] [Google Scholar]
  13. Greenstein A. J., Sachar D. B., Smith H., Janowitz H. D., Aufses A. H., Jr Patterns of neoplasia in Crohn's disease and ulcerative colitis. Cancer. 1980 Jul 15;46(2):403–407. doi: 10.1002/1097-0142(19800715)46:2<403::aid-cncr2820460232>3.0.co;2-6. [DOI] [PubMed] [Google Scholar]
  14. Harris O. D., Cooke W. T., Thompson H., Waterhouse J. A. Malignancy in adult coeliac disease and idiopathic steatorrhoea. Am J Med. 1967 Jun;42(6):899–912. doi: 10.1016/0002-9343(67)90071-x. [DOI] [PubMed] [Google Scholar]
  15. Hawker P. C., Gyde S. N., Thompson H., Allan R. N. Adenocarcinoma of the small intestine complicating Crohn's disease. Gut. 1982 Mar;23(3):188–193. doi: 10.1136/gut.23.3.188. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Holmes G. K., Dunn G. I., Cockel R., Brookes V. S. Adenocarcinoma of the upper small bowel complicating coeliac disease. Gut. 1980 Nov;21(11):1010–1015. doi: 10.1136/gut.21.11.1010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Jones T. R., Nance F. C. Periampullary malignancy in Gardner's syndrome. Ann Surg. 1977 May;185(5):565–573. doi: 10.1097/00000658-197705000-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Kenefick J. S. Carcinoma of the duodenum. Br J Surg. 1972 Jan;59(1):50–55. doi: 10.1002/bjs.1800590113. [DOI] [PubMed] [Google Scholar]
  19. Kuster G., Woods J. E., Anderson C. F., Weiland L. H., Wilkowske C. J. Plasma cell lymphoma after renal transplantation. Am J Surg. 1972 May;123(5):585–587. doi: 10.1016/0002-9610(72)90225-5. [DOI] [PubMed] [Google Scholar]
  20. Lillemoe K., Imbembo A. L. Malignant neoplasms of the duodenum. Surg Gynecol Obstet. 1980 Jun;150(6):822–826. [PubMed] [Google Scholar]
  21. Lowenfels A. B. Why are small-bowel tumours so rare? Lancet. 1973 Jan 6;1(7793):24–26. doi: 10.1016/s0140-6736(73)91228-2. [DOI] [PubMed] [Google Scholar]
  22. McPeak C. J. Malignant tumors of the small intestine. Am J Surg. 1967 Sep;114(3):402–411. doi: 10.1016/0002-9610(67)90164-x. [DOI] [PubMed] [Google Scholar]
  23. Miles R. M., Crawford D., Duras S. The small bowel tumor problem: an assessment based on a 20 year experience with 116 cases. Ann Surg. 1979 Jun;189(6):732–740. doi: 10.1097/00000658-197906000-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Mir-Madjlessi S. H., Farmer R. G., Hawk W. A. Villous tumors of the duodenum and jejunum. Report of four cases and review of the literature. Am J Dig Dis. 1973 Jun;18(6):467–476. doi: 10.1007/BF01076597. [DOI] [PubMed] [Google Scholar]
  25. Mittal V. K., Bodzin J. H. Primary malignant tumors of the small bowel. Am J Surg. 1980 Sep;140(3):396–399. doi: 10.1016/0002-9610(80)90176-2. [DOI] [PubMed] [Google Scholar]
  26. PAGTALUNAN R. J., MAYO C. W., DOCKERTY M. B. PRIMARY MALIGNANT TUMORS OF THE SMALL INTESTINE. Am J Surg. 1964 Jul;108:13–18. doi: 10.1016/0002-9610(64)90072-8. [DOI] [PubMed] [Google Scholar]
  27. Perzin K. H., Bridge M. F. Adenomas of the small intestine: a clinicopathologic review of 51 cases and a study of their relationship to carcinoma. Cancer. 1981 Aug 1;48(3):799–819. doi: 10.1002/1097-0142(19810801)48:3<799::aid-cncr2820480324>3.0.co;2-q. [DOI] [PubMed] [Google Scholar]
  28. Petreshock E. P., Pessah M., Menachemi E. Adenocarcinoma of the jejunum associated with nontropical sprue. Am J Dig Dis. 1975 Aug;20(8):796–802. doi: 10.1007/BF01070840. [DOI] [PubMed] [Google Scholar]
  29. ROCHLIN D. B., LONGMIRE W. P., Jr Primary tumors of the small intestine. Surgery. 1961 Oct;50:586–592. [PubMed] [Google Scholar]
  30. Reid J. D. Intestinal carcinoma in the Peutz-Jeghers syndrome. JAMA. 1974 Aug 12;229(7):833–834. [PubMed] [Google Scholar]
  31. Reiner M. A. Primary malignant neoplasms of the small bowel. Mt Sinai J Med. 1976 May-Jun;43(3):274–280. [PubMed] [Google Scholar]
  32. Reyes E. L., Talley R. W. Primary malignant tumors of the small intestine. Am J Gastroenterol. 1970 Jul;54(1):30–43. [PubMed] [Google Scholar]
  33. Sharon P., Stalnikovicz R., Rachmilewitz D. Endoscopic diagnosis of duodenal neoplasms causing upper gastrointestinal bleeding. J Clin Gastroenterol. 1982 Feb;4(1):35–38. doi: 10.1097/00004836-198202000-00006. [DOI] [PubMed] [Google Scholar]
  34. Silberman H., Crichlow R. W., Caplan H. S. Neoplasms of the small bowel. Ann Surg. 1974 Aug;180(2):157–161. doi: 10.1097/00000658-197408000-00005. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Treadwell T. A., White R. R., 3rd Primary tumors of the small bowel. Am J Surg. 1975 Dec;130(6):749–755. doi: 10.1016/0002-9610(75)90435-3. [DOI] [PubMed] [Google Scholar]
  36. Veen H. F., Oscarson J. E., Malt R. A. Alien cancers of the duodenum. Surg Gynecol Obstet. 1976 Jul;143(1):39–42. [PubMed] [Google Scholar]
  37. Voegele L. D., Moncrief J. A. Adenocarcinoma of the jejunum in an 18-year-old patient: a case report. Surgery. 1975 Aug;78(2):251–253. [PubMed] [Google Scholar]
  38. Vuori J. V. Primary malignant tumours of the small intestine. Analysis of cases diagnosed in Finland, 1953-1962. Acta Chir Scand. 1971;137(6):555–561. [PubMed] [Google Scholar]
  39. Wattenberg L. W. Studies of polycyclic hydrocarbon hydroxylases of the intestine possibly related to cancer. Effect of diet on benzpyrene hydroxylase activity. Cancer. 1971 Jul;28(1):99–102. doi: 10.1002/1097-0142(197107)28:1<99::aid-cncr2820280118>3.0.co;2-m. [DOI] [PubMed] [Google Scholar]
  40. Welch J. P., Malt R. A. Management of carcinoid tumors of the gastrointestinal tract. Surg Gynecol Obstet. 1977 Aug;145(2):223–227. [PubMed] [Google Scholar]
  41. Williamson R. C., Bauer F. L., Ross J. S., Watkins J. B., Malt R. A. Enhanced colonic carcinogenesis with azoxymethane in rats after pancreaticobiliary diversion to mid small bowel. Gastroenterology. 1979 Jun;76(6):1386–1392. [PubMed] [Google Scholar]
  42. Williamson R. C., Bauer F. L., Terpstra O. T., Ross J. S., Malt R. A. Contrasting effects of subtotal enteric bypass, enterectomy, and colectomy on azoxymethane-induced intestinal carcinogenesis. Cancer Res. 1980 Mar;40(3):538–543. [PubMed] [Google Scholar]
  43. Williamson R. C. Intestinal adaptation (first of two parts). Structural, functional and cytokinetic changes. N Engl J Med. 1978 Jun 22;298(25):1393–1402. doi: 10.1056/NEJM197806222982505. [DOI] [PubMed] [Google Scholar]
  44. Williamson R. C., Lyndon P. J., Tudway A. J. Effects of anticoagulation and ileal resection on the development and spread of experimental intestinal carcinomas. Br J Cancer. 1980 Jul;42(1):85–94. doi: 10.1038/bjc.1980.206. [DOI] [PMC free article] [PubMed] [Google Scholar]
  45. Wilson J. M., Melvin D. B., Gray G. F., Thorbjarnarson B. Primary malignancies of the small bowel: a report of 96 cases and review of the literature. Ann Surg. 1974 Aug;180(2):175–179. doi: 10.1097/00000658-197408000-00008. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES