Small bowel tumours Flashcards
What are the 3 types of small bowel tumours?
Adenocarcinoma
Lymphoma
Carcinoid tumours
Are primary or secondary tumours more common?
Primary tumours = rare
Secondary tumours = more common
Secondary tumours from where?
Ovary
Colon
Stomach
What is the most common primary tumour to be found in small bowel?
Adenocarcinoma
Where is adenocarcinoma most commonly found?
Duodenum & jejenum
Crohns is a predisposing factor to which small bowel tumour?
Adenocarcinoma
Management for adenocarcinoma?
Surgical resection
Radio
Chemo
Where in small bowel are lymphomas most commonly found?
Ileum
Most common type of lymphoma?
B cell arising from MALT
MALT?
Mucosa associated lymphoid tissue
Management of lymphoma?
Surgical resection
Radio
Chemo
What are carcinoid tumours?
A type of slow-growing neuroendocrine tumour
Where do carcinoid tumours originate from?
Enterochromaffin cells of intestine
Enterochromaffin cells?
They reside alongside the epithelium lining the lumen of the digestive tract and play a crucial role in GI regulation, particularly intestinal motility and secretion
Where are carcinoid tumours most commonly found?
Appendix and terminal ileum
Where do carcinoid tumours commonly metastasise to?
Liver
What do neuroendocrine cells secrete?
Hormones
Are carcinoid tumours mainly symptomatic or asymptomatic?
Asymptomatic
When does carcinoid syndrome tend to occur?
If tumour has metastasised
Carcinoid syndrome?
Collection of symptoms some get when a neuroendocrine tumour, usually one that has spread to the liver, releases hormones such as serotonin into the bloodstream.
Symptoms of carcinoid syndrome?
Spontaneous flushing
Diarrhoea
SOB/ wheezing
Pulmonary stenosis, tricuspid incompetence
Key substance which is overproduced in carcinoid syndrome & its effects?
Serotonin
Inc motility and peristalsis
Bronchoconstriction
Produce collagen via fibroblasts in the heart
Investigations for carcinoid tumours?
- Serum chromogranin A (marker for neuroendocrine tumours)
- 24hr urine 5- hydroxyindoleactic acid (5HIAA - Serotonin, measured in urine as (5HIAA), Elevated levels = correlated with carcinoid syndrome
- Radio imaging (mets)
Management for carcinoid tumours?
Surgical resection
Octreotide/ lanreotide (somatostatin analogues) -> inhibit release of hormones, dec symptoms
