BACKGROUND: Primary malignant neoplasms of the small bowel comprise only 1-3% of all gastrointestinal malignancies. Small bowel cancers pose a significant diagnostic challenge. The recent development of video capsule endoscopy (VCE) and device-assisted enteroscopy (DAE) have greatly facilitated evaluation of the small bowel. METHODS: We retrospectively reviewed all cases referred to a single U.S. center from September 2004 to July 2009 to determine the frequency and type of primary small bowel cancers found on DAE. RESULTS: The charts of 555 patients who underwent a total of 805 procedures (768 double-balloon and 37 rotational enteroscopies) were reviewed. A total of 20 patients with small bowel cancers were diagnosed. There was no gender predominance (ten men and ten women). The average age at presentation was 66 ± 11 years, essentially identical to our overall population. We identified eight neuroendocrine tumors, five adenocarcinomas, four GIST, two lymphomas, and one poorly differentiated carcinoma. CONCLUSIONS: Small bowel cancer is a rare but important finding on DAE. The per-patient incidence in our series was 3.6%. A recent multicenter Japanese series showing a higher incidence of small bowel tumors (14%) included polyposis syndrome patients and benign lesions, which were excluded from our study. The high frequency of neuroendocrine tumors in our series was also in contrast to the Japanese series, where lymphoma and GIST were more common. This may reflect a difference between our referral populations. Most of our patients underwent surgery as a consequence of these findings, underscoring the importance of identifying these tumors. DAE provides direct endoscopic access to the small bowel and is a valuable tool in the diagnosis of small bowel cancers.
BACKGROUND:Primary malignant neoplasms of the small bowel comprise only 1-3% of all gastrointestinal malignancies. Small bowel cancers pose a significant diagnostic challenge. The recent development of video capsule endoscopy (VCE) and device-assisted enteroscopy (DAE) have greatly facilitated evaluation of the small bowel. METHODS: We retrospectively reviewed all cases referred to a single U.S. center from September 2004 to July 2009 to determine the frequency and type of primary small bowel cancers found on DAE. RESULTS: The charts of 555 patients who underwent a total of 805 procedures (768 double-balloon and 37 rotational enteroscopies) were reviewed. A total of 20 patients with small bowel cancers were diagnosed. There was no gender predominance (ten men and ten women). The average age at presentation was 66 ± 11 years, essentially identical to our overall population. We identified eight neuroendocrine tumors, five adenocarcinomas, four GIST, two lymphomas, and one poorly differentiated carcinoma. CONCLUSIONS:Small bowel cancer is a rare but important finding on DAE. The per-patient incidence in our series was 3.6%. A recent multicenter Japanese series showing a higher incidence of small bowel tumors (14%) included polyposis syndromepatients and benign lesions, which were excluded from our study. The high frequency of neuroendocrine tumors in our series was also in contrast to the Japanese series, where lymphoma and GIST were more common. This may reflect a difference between our referral populations. Most of our patients underwent surgery as a consequence of these findings, underscoring the importance of identifying these tumors. DAE provides direct endoscopic access to the small bowel and is a valuable tool in the diagnosis of small bowel cancers.
Authors: Shahab Mehdizadeh; Andrew Ross; Lauren Gerson; Jonathan Leighton; Ann Chen; Drew Schembre; Gary Chen; Carol Semrad; Ahmad Kamal; Edwyn M Harrison; Kenneth Binmoeller; Irving Waxman; Richard Kozarek; Simon K Lo Journal: Gastrointest Endosc Date: 2006-11 Impact factor: 9.427
Authors: Lauren B Gerson; Jeffrey Tokar; Michael Chiorean; Simon Lo; G Anton Decker; David Cave; Doumit Bouhaidar; Daniel Mishkin; Charles Dye; Oleh Haluszka; Jonathan A Leighton; Alvin Zfass; Carol Semrad Journal: Clin Gastroenterol Hepatol Date: 2009-09-16 Impact factor: 11.382
Authors: Andrew Ross; Shahab Mehdizadeh; Jeffrey Tokar; Jonathan A Leighton; Ahmad Kamal; Ann Chen; Drew Schembre; Gary Chen; Kenneth Binmoeller; Richard Kozarek; Irving Waxman; Charles Dye; Lauren Gerson; M Edwyn Harrison; Oleh Haluszka; Simon Lo; Carol Semrad Journal: Dig Dis Sci Date: 2008-02-13 Impact factor: 3.199
Authors: Diana E Yung; Emanuele Rondonotti; Andry Giannakou; Tomer Avni; Bruno Rosa; Ervin Toth; Alfredo J Lucendo; Reena Sidhu; Hanneke Beaumont; Pierre Ellul; Lucian Negreanu; Victoria Alejandra Jiménez-Garcia; Deidre McNamara; Uri Kopylov; Luca Elli; Konstantinos Triantafyllou; Fahmi Shibli; Maria Elena Riccioni; Mauro Bruno; Xavier Dray; John N Plevris; A Koulaouzidis; Federico Argüelles-Arias; Aymeric Becq; Federica Branchi; María Ángeles Tejero-Bustos; Jose Cotter; Rami Eliakim; Francesca Ferretti; Ian M Gralnek; Juan Manuel Herrerias-Gutierrez; Mary Hussey; Maarten Jacobs; Gabriele Wurm Johansson; Mark McAlindon; Sara Montiero; Artur Nemeth; Marco Pennazio; Deepa Rattehalli; Ana Stemate; Annalisa Tortora; Georgios Tziatzios Journal: United European Gastroenterol J Date: 2017-02-01 Impact factor: 4.623
Authors: Marianny Sulbaran; Eduardo de Moura; Wanderley Bernardo; Cintia Morais; Joel Oliveira; Leonardo Bustamante-Lopez; Paulo Sakai; Klaus Mönkemüller; Adriana Safatle-Ribeiro Journal: Endosc Int Open Date: 2016-01-11