小腸的原發性腫瘤－10年105例的臨床分析

Primary Small Intestinal Tumors-A Clincal Analysis of 105 Cases in 10 Years

林錫銘(Shi-Ming Lin) ； 陳邦基(Pang-Chi Chen) ； 王嘉修(Chia-Siu Wang)

《中華民國消化系醫學會雜誌》 6卷1期 (1989/03) Pp. 9-15

https://doi.org/10.6557/GJTa.198903_6(1).0002

摘要

One hundred and five patients with histologically proven primary small intestinal tumors which was proved histologicilly from Jan. 1976 to Aug. 1987 were evaluated. There were 65 malignant and 40 benign tumors. The male to female ratio was 62 to 43 (1.4:1). The mean age at the time of diagnosis was 48 years and the age range was 2 to 84 years. Among the malignant tumors, there were adenocarcinomas in 26 (40%) patients, leiomyosarcoma in 26 (40%) patients, lymphomas in 11(17%) patients and carcinoid in 2 (3%) patients. Among the benign tumors, there were leiomyoma in 34 (85%) patients and the others included adenoma, lipoma, fibroma and polyps. The adenocarcinomas were mainly distributed in the duodenum (15/26) and jejunum (9/26). leiomyosarcomas in the jejunum (14/26) and lymphoma in the jejunum (3/11) and ileum (5/11). The leiomyomas were mainly distributed in the jejunum (20/34). Abdominal pain (66%), nausea or vomiting (49%), body weight loss (36%), melana (29%) and palpable abdominal mass (25%) were the five common manifestations. Nevertheless, 7 malignant tumors and 7 leiomyomas and 1 lipoma presented as surgical emergency, such as strangulated obstruction, intussusception or perforation with peritonitis, and needed emergent operation. Panendoscopy which was reached up to third portion of duodenum and barium meal examinations could provide good detectable rate as 90% and 88% respectively, computed tomography and ultrasonography of abdomen provide 83% and 73% detectable rate respectively, and the selective mesenteric arterial angiography could well detect bleeding lesion with 91% detectable rate in most of our cases. There was no difference in the time interval from S/S to detection, except, leiomyosarcoma took much longer time to be detected than leiomyoma (170±256 vs 52±170, p＜0.05). The treatment included resection in 58% of malignant tumors & all of benign tumors. chemotherapy & radiotherapy were only partly effective in lymphoma cases.

關鍵字

小腸腫瘤 ； 腺癌 ； 平滑肌肉瘤 ； 淋巴瘤 ； 平滑肌瘤

並列摘要

One hundred and five patients with histologically proven primary small intestinal tumors which was proved histologicilly from Jan. 1976 to Aug. 1987 were evaluated. There were 65 malignant and 40 benign tumors. The male to female ratio was 62 to 43 (1.4:1). The mean age at the time of diagnosis was 48 years and the age range was 2 to 84 years. Among the malignant tumors, there were adenocarcinomas in 26 (40%) patients, leiomyosarcoma in 26 (40%) patients, lymphomas in 11(17%) patients and carcinoid in 2 (3%) patients. Among the benign tumors, there were leiomyoma in 34 (85%) patients and the others included adenoma, lipoma, fibroma and polyps. The adenocarcinomas were mainly distributed in the duodenum (15/26) and jejunum (9/26). leiomyosarcomas in the jejunum (14/26) and lymphoma in the jejunum (3/11) and ileum (5/11). The leiomyomas were mainly distributed in the jejunum (20/34). Abdominal pain (66%), nausea or vomiting (49%), body weight loss (36%), melana (29%) and palpable abdominal mass (25%) were the five common manifestations. Nevertheless, 7 malignant tumors and 7 leiomyomas and 1 lipoma presented as surgical emergency, such as strangulated obstruction, intussusception or perforation with peritonitis, and needed emergent operation. Panendoscopy which was reached up to third portion of duodenum and barium meal examinations could provide good detectable rate as 90% and 88% respectively, computed tomography and ultrasonography of abdomen provide 83% and 73% detectable rate respectively, and the selective mesenteric arterial angiography could well detect bleeding lesion with 91% detectable rate in most of our cases. There was no difference in the time interval from S/S to detection, except, leiomyosarcoma took much longer time to be detected than leiomyoma (170±256 vs 52±170, p＜0.05). The treatment included resection in 58% of malignant tumors & all of benign tumors. chemotherapy & radiotherapy were only partly effective in lymphoma cases.

並列關鍵字

Smallintestinaltumor ； adenocarcinoma ； leiomyosarcoma ； lymphoma ； leiomyoma