title: Small intestinal adenocarcinoma: rarely considered, often missed?
abstract: Adenocarcinoma of the small intestine is rare in comparison with other gastrointestinal malignancies but its incidence is rising. It often presents at an advanced stage due to the non-specific symptomatology. More recent advances in small intestinal visualisation including video capsule endoscopy and double balloon enteroscopy may facilitate diagnosis in patients with suspected small intestinal neoplasia. At present aggressive surgical resection provides the best chance of cure of small intestinal adenocarcinoma. Despite apparent curative resection the long-term outlook remains poor. The role of adjuvant chemotherapy is not well defined due to the rarity of the disease and lack of randomised controlled trials; however, there appears to be a survival benefit in advanced disease with the use of oxaliplatin and 5-fluorouracil. We reviewed the clinical aspects of this aggressive condition focusing on the pathological associations, available diagnostic modalities and current management options. Three cases are included to illustrate the review.
authors: Department of Surgery, Northern Health and Social Care Trust, Causeway Hospital, Newbridge Road, Coleraine, UK. dneely01@qub.ac.uk
authors: David
authors: D
authors: Neely
authors: Justin
authors: J
authors: Ong
authors: James
authors: J
authors: Patterson
authors: Dianne
authors: D
authors: Kirkpatrick
authors: Roderick
authors: R
authors: Skelly
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D000368:Aged; D053704:Capsule Endoscopy; D002446:Celiac Disease / Q000150:complications / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D003550:Cystic Fibrosis / Q000150:complications / Q000473:pathology; D058582:Double-Balloon Enteroscopy; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use*; D006801:Humans; D007414:Intestinal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D007421:Intestine, Small / Q000473:pathology*; D008297:Male; D009325:Nausea; D009944:Organoplatinum Compounds / Q000627:therapeutic use*; D000077150:Oxaliplatin; D011379:Prognosis; D012680:Sensitivity and Specificity; D015431:Weight Loss
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D005472:Fluorouracil