Clinical Reviews: The Small Intestine and NutritionSmall Intestinal NeoplasmsGill, Satinder S. M.D.; Heuman, Douglas M. M.D.; Mihas, Anastasios A. M.D.Author Information From the Division of Gastroenterology, Medical College of Virginia, Commonwealth Virginia University, Richmond, Virginia, U.S.A. (S.S.G., D.M.H., A.A.M.); and McGuire Veterans Affairs Medical Center, Richmond, Virginia, U.S.A. (D.M.H., A.A.M.). Address correspondence and reprint requests to Dr. A.A. Mihas, Division of Gastroenterology, McGuire VAMC (111N), 1201 Broad Rock Road, Richmond, VA 23249, U.S.A. E-mail: [email protected] med.va.gov Journal of Clinical Gastroenterology: October 2001 - Volume 33 - Issue 4 - p 267-282 Buy Abstract Small intestinal neoplasms are uncommonly encountered in clinical practice. They may occur sporadically, in association with genetic diseases (e.g., familial adenomatous polyposis coli or Peutz–Jeghers syndrome), or in association with chronic intestinal inflammatory disorders (e.g., Crohn's disease or celiac sprue). Benign small intestinal tumors (e.g., leiomyoma, lipoma, hamartoma, or desmoid tumor) usually are asymptomatic but may present with intussusception. Primary malignancies of the small intestine—including adenocarcinoma, leiomyosarcoma, carcinoid, and lymphoma—may present with intestinal obstruction, jaundice, bleeding, or pain. Extraintestinal neoplasms may involve the intestine via contiguous spread or peritoneal metastasis. Hematogenous metastases to the intestine from an extraintestinal primary are unusual and are most typical of melanoma. Because the small intestine is relatively inaccessible to routine endoscopy, diagnosis of small intestinal neoplasms is often delayed for months after onset of symptoms. When the diagnosis is suspected, enteroclysis is the most useful imaging study. Small bowel endoscopy (enteroscopy) is increasingly widely available and may permit earlier, nonoperative diagnosis. © 2001 Lippincott Williams & Wilkins, Inc.