Tumores primarios del yeyuno-íleon: correlación clínico-patológica

Abstract

Background: Short bowel tumors correspond to 2% of gastrointestinal tract tumors and are the third cause of bowel obstruction. Aim: To perform a clinico-pathological correlation of jejunoileal tumors. Patients and Methods: Retrospective revision of medical records of patients operated for a primary jejunoileal tumor in a period of 17 years, excluding duodenal tumors. Results: Twenty four patients were identified, seven had gastrointestinal stromal tumors (GIST), six had a carcinoid tumor and five had lymphomas. GIST predominantly involved distal jejunum and proximal ileum, while carcinoid tumors and lymphomas tended to involve the distal ileum. The main clinical presentation of GIST was gastrointestinal bleeding. Carcinoid tumors presented mostly as bowel occlusion and lymphomas as bowel perforation. Benign lesions tended to present as intussusception. CAT scan and CAT enteroclysis allowed the preoperative diagnosis in 20 patients. Immunohistochemistry was relevant for the pathological diagnosis and radical surgery was the basis of treatment. Prognosis depended on the pathology of the tumor, the degree of malignancy and the tumor stage at the moment of diagnosis. Conclusions: Excluding duodenum, GIST and carcinoid tumors account for 65% of primary malignant tumors of jejunum and ileum. Some clues for the diagnosis can be obtained from the clinical picture of the patients.