Deck K B, Silverman H
Cancer. 1979 Jul;44(1):323-5. doi: 10.1002/1097-0142(197907)44:1<323::aid-cncr2820440155>3.0.co;2-g.
Small bowel leiomyosarcomas are uncommon but potentially curable tumors often diagnosed at an advanced stage. Twenty such lesions were studied, and 19 of these produced symptoms and signs. Clinical findings included abdominal pain in 17 (85%), rectal bleeding in 8 (40%), anemia in 7 (35%), intraperitoneal perforation in 6 (30%), and abdominal mass in 4 (20%). Various abdominal x-ray examinations revealed nonspecific abnormalities (ileus, bowel obstruction, abdominal mass) in about half the cases in which they were obtained, but in only one instance was the correct diagnosis of small bowel tumor made preoperatively. Five of 12 patients undergoing resection in hope of cure survived five years. These tumors tend to metastasize by hematogenous dissemination, peritoneal implantation, local invasion, and, uncommonly, lymphogenous spread. Wide small bowel resection with adjacent mesentery is suggested for most lesions. Five year survival following resection approximates 50% in reported series.
小肠平滑肌肉瘤并不常见，但却是有可能治愈的肿瘤，通常在晚期才被诊断出来。对20例此类病变进行了研究，其中19例出现了症状和体征。临床表现包括腹痛17例（85%）、直肠出血8例（40%）、贫血7例（35%）、腹腔穿孔6例（30%）以及腹部肿块4例（20%）。各种腹部X线检查在约半数接受检查的病例中显示出非特异性异常（肠梗阻、肠阻塞、腹部肿块），但术前仅1例正确诊断出小肠肿瘤。12例希望通过切除治愈的患者中有5例存活了5年。这些肿瘤倾向于通过血行播散、腹膜种植、局部侵犯转移，罕见情况下也会通过淋巴转移。对于大多数病变，建议进行广泛的小肠切除及相邻肠系膜切除。在已报道的系列研究中，切除术后的5年生存率约为50%。
