Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + • Often asymptomatic or subtly symptomatic-Symptomatic tumors are more likely to be malignant• Benign tumors are more likely pedunculated and more commonly cause intussusception• May be a cause of GI bleeding +++ Epidemiology +++ Adenoma + • Tubular-Low malignant potential-Can cause obstruction or intussusception• Villous-Significant malignant potential, associated with inherited colonic polyposis syndromes• Brunner gland: No malignant potential +++ Stromal Tumors + • Mesenchymal neoplasms• The most common symptomatic benign neoplasm• Most in the jejunum• Associated with ulceration, bleeding, and obstruction +++ Lipomas + • Most in the ileum, may cause obstruction• No malignant potential +++ Hamartomas + • Part of Peutz-Jeghers syndrome• Polypoid and may cause intermittent intussusception and bleeding• Rare malignant potential +++ Hemangiomas + • Small and diffuse or large and isolated, can be a source of recurrent GI hemorrhage +++ Symptoms and Signs + • Often asymptomatic• Abdominal pain• GI bleeding• Abdominal distention• Abdominal tenderness +++ Laboratory Findings + • Anemia +++ Imaging Findings + • Contrast radiography or enteroclysis: May visualize tumor as a filling defect or mass lesion.• CT scan: Mass may be visualized after administration of contrast• Endoscopy-Most lesions are inaccessible-Allows direct visualization as well as biopsy for diagnosis + • Most benign tumors of the small intestine are asymptomatic-When symptoms occur, they are often related to obstruction, intussusception, or bleeding• Differentiating benign from malignant stromal tumors may be difficult +++ Rule Out + • Malignant tumors + • Contrast radiography• CT scan• Endoscopy if feasible +++ When to Admit + • High-grade obstruction• Bleeding + • Many benign tumors require no specific treatment if asymptomatic +++ Surgery + • Symptomatic lesions require either resection or endoscopic excision +++ Indications + • Symptoms (obstruction, bleeding)• Tubular or villous adenomas• All stromal tumors• Large or extensive hemangiomas• Large hamartomas +++ Complications + • Obstruction• Bleeding• Intussusception +++ Prognosis + • Good after resection of benign lesions +++ References ++Blanchard DK et al. Tumors of the small intestine. World J Surg. 2000;24:421. [PubMed: 10706914] ++Gore RM et al: Diagnosis and staging of small bowel tumours. Cancer Imaging 2006;6:209. [PubMed: 17208678] ++Hyland R, Chalmers A: CT features of jejunal pathology. Clin Radiol 2007;62:1154. [PubMed: 17981162] ++Miettinen M, Lasota J: Gastrointestinal stromal tumors: review on morphology, ... Your MyAccess profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth