Sarcoma of the small intestine: causes, symptoms, diagnosis, treatment

Sarcoma of the small intestine is very rare. According to statistics, small intestine sarcoma is found in 0.003% of cases.

Sarcoma of the small intestine is more common in men, moreover, at a relatively young age. The overwhelming number of sarcomas is related to round-cell and spindle cell lymphosarcomas.

Symptoms, course, complications. The clinic of small intestine sarcoma is diverse. A frequent symptom is pain. However, in the first period undefined complaints prevail, so that until the moment when a mobile tumor begins to be probed, it is hardly possible to suspect a sarcoma of the small intestine.

Since small intestine sarcomas are very rare, the clinic of this disease has been poorly studied and there are some contradictions in the description of the frequency of these or those symptoms. Bleeding is a common symptom. The more frequent occurrence of intestinal bleeding in sarcomas than in cancers of the small intestine is explained by the much larger size of tumors, rich blood supply and increased tendency to decay and ulceration.

Intestinal permeability with sarcomas for a long time is not disturbed; in 80% of cases it is not violated at all. Obstruction can be caused not by stenosis of the lumen of the intestine, but by intussusception. The perforation of small intestine sarcomas is extremely rare.

Many authors note the rapid growth of sarcomas. In the literature there is a report about the case when in 2 weeks the sarcoma of the small intestine increased 10-fold. Some authors point to their slow growth with sudden acceleration over a period of time as a distinctive sign of sarcoma. The growth rate is usually explained by the maturity of the tumor: immature circlet cells grow rapidly, more mature - spindle cell and fibrosarcoma - much slower.

A tumor in 75% of cases gives metastases to the lymph nodes. However, in the literature, the ability of sarcomas, in contrast to cancer, to determine hematogenous metastases; according to some reports, this is more common with more mature sarcomas. Of distant metastases, liver metastases are more common (approximately 1/3 of the cases).

The outlook is unfavorable. However, more encouraging information has appeared recently. So, according to a number of authors, almost half of patients operated on for small intestine leiomyosarcoma have lived more than 5 years.

All, without exception, the authors note the great difficulties in diagnosing this disease. X-ray examination should be carried out necessarily, but pathognomonic X-ray picture for small intestine sarcoma is not present. Even laparotomy in some cases does not bring necessary clarity.

The diagnosis of sarcoma (and other tumors) of the small intestine is established based on the data of X-ray and ultrasound, computed tomography, laparoscopy. However, since the tumor is asymptomatic for a certain period of time, these studies are usually used already with the developed complications: profuse intestinal bleeding, obstructive small intestinal obstruction, etc., or in cases of "causeless" strong weight loss of the patient, acceleration of ESR (examination in " order of oncological search ").

The prognosis is poor: without treatment all patients die.

Treatment of small intestine sarcoma is surgical.

[1], [2], [3], [4]