Dong X Y, Li Y L, Yao J N, Zhang L F
Department of Gastroenterology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
Zhonghua Yi Xue Za Zhi. 2024 Jun 4;104(21):2003-2006. doi: 10.3760/cma.j.cn112137-20240311-00551.
To investigate the clinical characteristics of metastatic tumors in small intestine. The clinical manifestations, imaging and endoscopic findings, treatment methods and follow-up of patients with small bowel metastatic tumors admitted to the First Affiliated Hospital of Zhengzhou University from January 1, 2018 to December 31, 2022 were retrospectively analyzed. A total of 10 patients were included, including 7 males and 3 females, aged 33-77 (56.4±12.6) years. The main clinical manifestations were intestinal obstruction (8 cases), such as abdominal pain, abdominal distension, nausea, vomiting, and reduced defecation. Some patients had intussusception (abdominal pain, vomiting, black stool and other symptoms, 1 case) or gastrointestinal bleeding (1 case) with early symptoms imperceptible. The primary tumors include gastric cancer (3 cases), malignant melanoma (2 cases), ovarian cancer (2 cases), colon cancer (1 case), rectal cancer (1 case), and lung cancer (1 case). Most of the primary tumors were poorly differentiated (6 cases) or moderately to poorly differentiated (2 cases). The median time from primary tumor surgery to detection of small bowel metastasis [ ()] was 22 (18, 28) months.The metastatic lesions were single (6 cases) or multiple (4 cases), in both jejunum and ileum. Positron emission tomography-computed tomography (PET-CT, 3 cases) and endoscopy (2 cases) were helpful for detection of small intestinal metastases. The main treatment methods were surgical resection (9 cases), supplemented by radiotherapy, targeted drugs, immunotherapy, etc. Postoperative recurrence and metastasis occurred in some patients (5 cases). Most patients died within 4 to 29 months after diagnosis. Metastatic tumors in small intestine are rare in clinical practice with atypical early symptoms. The patients often present with complications such as intestinal obstruction, which is prone to delayed diagnosis and poor prognosis.
探讨小肠转移性肿瘤的临床特征。回顾性分析2018年1月1日至2022年12月31日郑州大学第一附属医院收治的小肠转移性肿瘤患者的临床表现、影像学及内镜检查结果、治疗方法及随访情况。共纳入10例患者，其中男性7例，女性3例，年龄33 - 77（56.4±12.6）岁。主要临床表现为肠梗阻（8例），如腹痛、腹胀、恶心、呕吐及排便减少。部分患者有肠套叠（腹痛、呕吐、黑便等症状，1例）或消化道出血（1例），早期症状不明显。原发肿瘤包括胃癌（3例）、恶性黑色素瘤（2例）、卵巢癌（2例）、结肠癌（1例）、直肠癌（1例）和肺癌（1例）。大多数原发肿瘤为低分化（6例）或中低分化（2例）。从原发肿瘤手术至发现小肠转移的中位时间[（）]为22（18，28）个月。转移灶为单发（6例）或多发（4例），位于空肠和回肠。正电子发射断层扫描 - 计算机断层扫描（PET - CT，3例）和内镜检查（2例）有助于小肠转移灶的检测。主要治疗方法为手术切除（9例），辅以放疗、靶向药物、免疫治疗等。部分患者术后出现复发和转移（共5例）。大多数患者在诊断后4至29个月内死亡。小肠转移性肿瘤在临床实践中较为罕见，早期症状不典型。患者常出现肠梗阻等并发症，易延误诊断且预后较差。
