R. Orda, J. Sayfan, I. Wasserman
Department of Surgery 'A', Assaf Harofeh Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
Malignant tumors of the small intestine are rare. An uncommon finding of leiomyosarcoma located in the fourth part of the duodenum was diagnosed by gastrointestinal contrast studies, CT and angiography. Although malignant lesions of the small bowel are usually diagnosed late and thus are far advanced, curative resection was possible in our case. The location and histology of the tumor permitted a 'pancreas-preserving segmental duodenectomy'. The operative approach and exposure using the Cattell maneuver is described. It is emphasized that the more extensive pancreatoduodenectomy should be reserved for adenocarcinomas or lesions situated in the proximal part of the duodenum. Thirteen years following the operation, the patient is asymptomatic while CT and gastrointestinal contrast studies reveal no evidence of disease.
Alternative Names Mass; Neoplasm
Definition Return to top
A tumor is an abnormal growth of body tissue. Tumors can be cancerous (malignant) or non-cancerous (benign).
Causes Return to top
In general, tumors appear to occur when there is a problem with the dividing of cells in the body. Typically, the division of cells in the body is strictly controlled. New cells are created to replace older ones or to perform new functions. Cells that are damaged or no longer needed die to make room for healthy replacements.
If the balance of cell division and death is disturbed, a tumor may form.
Problems with the body's immune system can lead to tumors. Tobacco causes more deaths from cancer than any other environmental substance. Other causes include:
- Benzene and other chemicals and toxins
- Drinking excess alcohol
- Excessive sunlight exposure
- Genetic problems
- Inactivity (sedentary lifestyle)
- Obesity
- Radiation
Certain viruses can play a role in the development of tumors, such as cervical cancer (human papillomavirus) and hepatocellular carcinoma (hepatitis B virus).
Some tumors are more common in one gender than the other. Some are more common among children or the elderly. Others vary with diet, environment, and your family history.
Symptoms Return to top
Symptoms depend on the type and location of the tumor. For example, lung tumors may cause coughing, shortness of breath, or chest pain, while tumors of the colon can cause weight loss, diarrhea, constipation, iron deficiency anemia, and blood in the stool.
Some tumors produce no symptoms, but symptoms that may occur with tumors include:
Exams and Tests Return to top
Like the symptoms, the signs of tumors vary based on their site and type.
When a tumor is found, a biopsy is performed to determine if the tumor is non-cancerous (benign) or cancerous (malignant). Depending on the location of the tumor, the biopsy may be a simple procedure or a serious operation.
Most patients with tumors undergo CT scans or MRI to determine the exact location of the tumor and how far it has spread. More recently, positron emission tomography (PET) scans have been used to find certain tumor types.
Other tests include:
- Biopsy of the tumor
- Blood chemistries
- Bone marrow biopsy (most often for lymphoma or leukemia)
- Chest x-ray
- Complete blood count (CBC)
Treatment Return to top
Treatment also varies based on the type of tumor, whether it is benign or malignant, and its location. If the tumor is benign (meaning it has no potential to spread) and is located in a "safe" area where it will not cause symptoms or affect the function of the organ, sometimes no treatment is needed.
Sometimes benign tumors may be removed for cosmetic reasons, however. Benign tumors of the brain may be removed because of their location or harmful effect on the surrounding normal brain tissue.
If a tumor is malignant, treatments include:
- Surgery
- Radiation
- Chemotherapy
- A combination of these methods
If the cancer is in one location, the goal of treatment is usually to remove the tumor with surgery. If the tumor has spread to local lymph nodes only, sometimes these can also be removed. If all of the cancer cannot be removed with surgery, the options for treatment include radiation and chemotherapy, or both. Some patients require a combination of surgery, radiation and chemotherapy.
However, lymphoma is rarely treated with surgery. Chemotherapy and radiation therapy are most often used for treating lymphoma.
Support Groups Return to top
The diagnosis of cancer often causes a lot of anxiety and can affect a patient's entire life. There are many resources for cancer patients (see cancer resources).
Outlook (Prognosis) Return to top
The outlook varies widely among different types of tumors. If the tumor is benign, the outlook is generally very good. However, there are some instances where a benign tumor can cause significant problems, for instance, in the brain.
If the tumor is malignant, the outcome depends on the stage of the tumor at diagnosis. Some cancers can be cured. Some that are not curable can still be treated and patients can live for many years with the cancer. Still other tumors are quickly life-threatening.
Possible Complications Return to top
Complications can occur if a tumor is located in a region of the body where it affects the function of the normal organ. If the tumor is malignant, it can also cause complications if it spreads (metastasizes).
When to Contact a Medical Professional Return to top
Call your health care provider if you notice any suspicious lumps or bumps on your body, or if you notice a new or changing mole on your skin.
Prevention Return to top
You can reduce the risk of cancerous (malignant) tumors by:
- Eating a healthy diet
- Exercising regularly
- Limiting alcohol
- Maintaining a healthy weight
- Minimizing exposure to radiation and toxic chemicals
- Not smoking or chewing tobacco
- Reducing sun exposure if you burn easily
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