Primary tumors of the small intestine

From 1950 through 1984, 48 cases of primary tumors of the small bowel were treated at the First Surgical Clinic of the University, La Sapienza, of Rome. Forty-three were malignant and five were benign tumors: 13 in the duodenum, 16 in the jejunum and 19 in the ileum. Abdominal pain, weight loss and obstruction were the most common complaints at admission. Radiographic studies of the gastrointestinal tract were diagnostic in 48% of patients. Four benign tumors were leiomyoma of the jejunum or ileum, the other benign tumor was a Brunner's adenomatosis of the duodenal bulb. The tumors were adenocarcinomatous in 29% of the cases and 50% of them were located in the duodenum. The five-year survival of patients with adenocarcinoma was 11%. The fourteen lymphomas were distributed evenly throughout the small bowel: 40% of the patients with lymphoma were alive after five years. Malignant smooth muscle tumors were found in the jejunum and ileum, in these cases the five-year survival rate was 50%. All the carcinoid tumors were in the ileum. The best five-year survival rate, 66%, was seen in patients with this type of tumor. In the malignant group, the five-year survival rate after curative resections was 25% in patients with positive nodes and 75% in those without nodal involvement.