Dr Adam Bailey and colleagues from Australia examined diagnosis and outcome in small bowel tumors detected by capsule endoscopy.
The research team prospectively collected data from 416 capsule endoscopies across 3 medical centers.
The team identified 27 tumors in 26 patients.
Clinical parameters, tumor histology, and follow-up were recorded.
Indications for capsule endoscopy were obscure gastrointestinal bleeding in 21 patients, suspected tumor in 3, abdominal pain in 1, and diarrhea in 1.
Prior radiology found a possible lesion in 35%.
The team noted that 9 tumors were proven benign.
Of these tumors, 4 were hamartomas, 1 was a cystic lymphangioma, a further 1 was a primary amyloid, and 1 was a lipoma.
The researchers found that 2 lesions were non-neoplastic, including heterotopic gastric mucosa and an inflammatory fibroid polyp.
| Prior radiology found a possible lesion in 35%|
|American Journal of Gastroenterology|
The team observed that 17 tumors were malignant.
The research team found that 5 malignant tumors were adenocarcinomas, 6 were carcinoids.
A further 2 malignant tumors were melanoma metastases, and 2 were gastrointestinal stromal tumors.
The team observed that 1 of the malignant tumors was a colon carcinoma metastasis, and 1 was non-Hodgkin's lymphoma.
Tumors were surgically resected in 23 patients.
The team noted that resection was considered curative in 52%.
Mean duration of follow-up was 26 months.
Of the 5 patients with primary adenocarcinoma only 1 remained disease free.
The researchers reported that 3 of the 6 with carcinoid tumors have had no recurrence up to 51 months postresection.
Both patients with gastrointestinal stromal tumors continued to be disease free.
In addition, the team observed that anemia resolved after surgery in the patients with melanoma.
Dr Bailey's team concludes, “Small bowel tumors are a significant finding at capsule endoscopy and are often missed by other methods of investigation.”
“In many patients, detection of a tumor alters management and improves outcome.”
“Even in malignant lesions, treatment is potentially curative in the absence of metastatic disease.”