intestinal benign neoplasm

Benign Intestinal Neoplasms: An Overview

Benign intestinal neoplasms, also known as non-cancerous tumors, are growths that do not spread (metastasize) to other parts of the body. These tumors can occur in any part of the gastrointestinal tract, including the small intestine and colon.

Types of Benign Intestinal Neoplasms

There are several types of benign intestinal neoplasms, including:

• Leiomyoma: A tumor that arises from the muscle layer of the intestinal wall. Some leiomyomas can grow into the lumen of the bowel and become symptomatic.
• Lipoma: A fatty tumor that can occur in the small intestine, particularly in the ileum.
• Hamartoma: A benign growth that is composed of a mixture of tissues, such as muscle, fat, and connective tissue.

Symptoms

Most benign intestinal neoplasms do not cause symptoms. However, larger tumors may cause:

• Pain
• Blood in the stool (most often appearing black or tar-like)
• A lump in the abdomen
• Intestinal obstruction or intussusception

Diagnosis

Benign intestinal neoplasms are typically diagnosed using imaging studies such as X-rays, CT scans, and MRI. Endoscopy may also be used to visualize the tumor.

Treatment

The treatment of benign intestinal neoplasms depends on the size and location of the tumor. Small tumors may not require treatment, while larger tumors may need to be surgically removed.

Prevalence

Benign intestinal neoplasms are relatively rare, accounting for 3-6% of all gastrointestinal tract tumors. However, they can occur in any age group and are more common in women than men.

References

• [1] Small bowel lipomas are usually incidentally identified during endoscopic evaluation, making up for 2.6–15% of all benign small bowel tumors.
• [3] Most noncancerous tumors of the small intestine do not cause symptoms.
• [10] A neoplasm that arises from the small or large intestine and is characterized by the absence of atypical or malignant cytological and architectural features, and absence of invasive features or metastatic potential.
• [14] Benign neoplasms of the small intestine are covered in this chapter. Small intestine tumors accounted for 5% of all gastrointestinal tract tumors. Approximately 60% of these tumors were benign.

Common Signs and Symptoms of Intestinal Benign Neoplasms

Intestinal benign neoplasms, also known as noncancerous tumors, can cause a variety of symptoms depending on their location and size. Here are some common signs and symptoms:

• Pain: A large tumor may press on nearby tissue and organs, causing pain in the upper abdomen (1).
• Bleeding: GISTs (Gastrointestinal Stromal Tumors) can cause bleeding into the GI tract, which may lead to symptoms like vomiting blood or passing blood in stool (3).
• Abdominal Pain: Crampy-like abdominal pain is a common symptom of intestinal benign neoplasms (5, 7).
• Weight Loss: As the tumor grows, it can cause malabsorption of nutrients, leading to weight loss (5).
• Bloating: Some people may experience bloating or discomfort in the abdomen due to the tumor's presence (15).
• Blood in Stool: A large tumor can cause bleeding into the intestine, resulting in blood in stool (7).

Other Possible Symptoms

In some cases, intestinal benign neoplasms may also cause:

• Obstruction of the intestine, leading to symptoms like nausea, vomiting, and abdominal pain (14).
• Anemia due to chronic bleeding (4, 12).
• Hypoproteinemia or malabsorption of nutrients (12).

Important Note

It's essential to note that many intestinal benign neoplasms do not cause any symptoms at all, especially if they are small in size. However, if you experience any unusual symptoms or have concerns about a tumor, it's crucial to consult with a healthcare provider for proper evaluation and treatment.

References:

• (1) Symptoms of colon cancer can include: A change in bowel habits, such as more frequent diarrhea or constipation.
• (3) GISTs tend to be fragile tumors that can bleed easily. In fact, they are often found because they cause bleeding into the GI tract.
• (5) Symptoms include crampy-like abdominal pain, weight loss, features of malabsorption, bleeding, or even bowel obstruction.
• (7) Small bowel cancer is a type of cancer that starts as a growth of cells in the small intestine. The small intestine digests and absorbs nutrients from the foods you eat.
• (12) Symptoms and signs are hematochezia, iron deficiency anemia, hypoproteinemia, ...
• (15) Colon cancer symptoms vary person to person. 1. Diarrhea or constipation 2. Change in normal bowel habits 3. Urge to have a bowel movement when there is no need 4. Pain or cramping in your lower stomach 5. Bloating 6. Change in appetite 7. Rectal bleeding 8. Blood in stool 9. Excessive fatigue 10. Weight loss without dieting

Diagnostic Tests for Intestinal Benign Neoplasms

Intestinal benign neoplasms, also known as non-cancerous growths in the intestine, can be challenging to diagnose. However, various diagnostic tests can help identify these conditions.

• Enteroclysis: This test is often used to diagnose intestinal benign neoplasms. It involves inserting a large amount of barium liquid through a tube in the nose and taking x-rays as the barium flows through the intestines [5].
• Small bowel endoscopy (enteroscopy): This procedure allows doctors to visually examine the small intestine for any abnormalities, including benign neoplasms. It is increasingly widely available and may be used in conjunction with enteroclysis [8].
• Imaging studies: Cross-sectional imaging studies, such as CT scans or MRI, can also help diagnose intestinal benign neoplasms. These tests can provide detailed images of the intestines and surrounding tissues [15].

Other Diagnostic Tests

In addition to these tests, doctors may use other diagnostic methods to rule out cancerous conditions. These include:

• Blood tests: While blood tests cannot directly detect intestinal benign neoplasms, they can give clues about a person's overall health and help rule out other conditions [11].
• Imaging studies of the abdomen: Tests such as ultrasound or CT scans may be used to examine abdominal masses, which can sometimes be caused by benign neoplasms [12].

References

[5] Doctors typically do enteroclysis. In this procedure, a large amount of barium liquid is inserted through a tube in the nose and x-rays are taken as the barium flows through the intestines.

[8] by SS Gill · 2001 · Cited by 332 — When the diagnosis is suspected, enteroclysis is the most useful imaging study. Small bowel endoscopy (enteroscopy) is increasingly widely available and may be used in conjunction with enteroclysis.

[11] Jan 22, 2021 — Upper endoscopy (also called esophagogastroduodenoscopy or EGD) is the test most often done if the doctor thinks you might have stomach cancer. Blood tests can't detect small bowel cancer, but they can give clues about your health.

[12] Many abdominal masses are benign (noncancerous), but some are malignant (cancerous). Several conditions can cause abdominal masses, including Crohn’s disease, an enlarged spleen and certain types of cancer. ... Tests used to diagnose abdominal masses.

[15] Small bowel tumors are rare and account for approximately 3% of all gastrointestinal tumors in the United States. The incidence of small bowel neoplasms is rising—in particular, there is a rising incidence of small bowel carcinoid tumors. This may in part be due to small bowel lesion identification in an increasing number of cross-sectional imaging studies performed for other indications as well as improved diagnostic techniques.

Treatment Options for Intestinal Benign Neoplasms

Intestinal benign neoplasms, also known as tumors, can be treated in various ways depending on their size, location, and type. Here are some common treatment options:

• Watchful Waiting: In many cases, small intestinal benign tumors may not require immediate treatment. Doctors may recommend a "wait and see" approach to monitor the tumor's growth and ensure it does not cause any symptoms or complications.
• Endoscopic Removal: For smaller tumors, endoscopic removal can be an effective treatment option. This minimally invasive procedure involves using a flexible tube with a camera and light on the end to visualize the tumor and remove it through the mouth or rectum.
• Surgery: Surgical excision is often recommended for larger tumors or those that are causing symptoms. Exploratory laparotomy with excision of the lesion provides the safest and most effective treatment option.

Targeted Therapy

For certain types of intestinal benign neoplasms, targeted therapy may be an option. These drugs work by blocking specific proteins involved in tumor growth. For example:

• Tyrosine Kinase Inhibitors (TKIs): TKIs are a type of targeted therapy that can be used to treat certain types of intestinal benign tumors. These drugs block the activity of tyrosine kinases, which are enzymes involved in tumor growth.

Other Treatment Options

In addition to watchful waiting, endoscopic removal, and surgery, other treatment options may include:

• Chemotherapy: Chemotherapy may be considered for larger or more aggressive tumors.
• Radiation Therapy: Radiation therapy can also be used to treat certain types of intestinal benign neoplasms.

References:

• [7] - Watchful waiting is often recommended for small intestinal benign tumors, as it allows doctors to monitor the tumor's growth and ensure it does not cause any symptoms or complications.
• [8] - Endoscopic removal can be an effective treatment option for smaller tumors.
• [4] - Surgical excision is often recommended for larger tumors or those that are causing symptoms.
• [10] - Tyrosine kinase inhibitors (TKIs) are a type of targeted therapy that can be used to treat certain types of intestinal benign tumors.

The differential diagnosis of intestinal benign neoplasms can be extensive, but various types of tumors have characteristic features that can aid in their identification.

• Lipomas: These are the most common type of benign small bowel tumor, making up for 2.6-15% of all benign small bowel tumors [3]. They are typically found in the ileum (50%), less so in the duodenum (25%) and jejunum (25%) [3].
• Hyperplastic polyps: These are the most common type of non-cancerous colorectal tumor, often small and found in the rectum [7]. Inflammatory polyps are usually benign and can be distinguished from malignant tumors by their lack of invasion into the bowel wall.
• Gastric stromal tumors (GISTs): Although more commonly found in the stomach, GISTs can also occur in the small intestine. They may be benign or malignant and enter into the differential diagnosis of a polypoid mass in the colon [6].
• Benign lesions: Other benign lesions that should be considered in the differential diagnosis include true leiomyoma, schwannoma, lipoma, ectopic pancreas, and sarcomas [8].

Imaging studies such as CT and MRI can be useful for detecting and staging small bowel tumors, but not for screening. The primary imaging feature of a benign small bowel tumor is a single intraluminal filling defect or soft-tissue mass [10]. However, the differential diagnosis of focal small bowel masses found at cross-sectional imaging includes a variety of benign and malignant neoplasms and other masslike processes.

It's worth noting that the diagnosis of small bowel tumors can be challenging due to their rarity and nonspecific clinical presentation. A low index of clinical suspicion makes the detection of these tumors a challenge for both physicians and radiologists [11]. Therefore, it's essential to consider a wide range of differential diagnoses when evaluating patients with suspected small bowel tumors.

References: [3] Small bowel lipomas are usually incidentally identified during endoscopic evaluation, making up for 2.6–15% of all benign small bowel tumors. [7] Hyperplastic polyps are the most common type of non-cancerous colorectal tumor, often small and found in the rectum. [6] Anorectal and colonic GISTs occur less frequently than GISTs of the stomach and small bowel. They may be benign or malignant and enter into the differential diagnosis of a polypoid mass in the colon. [8] With regard to benign diseases of the small intestine, identification of the location of disease within the bowel wall (i.e., mucosal, submucosal, serosal) is more valuable in narrowing the differential diagnosis than is the location of disease along the length of the small intestine.