Clinical time course and CT detection of metastatic disease to the small bowel

Abdominal Radiology
Megan H LeeElliot K Fishman

Abstract

The purpose of this study was to identify the CT characteristics of metastatic disease of the small bowel and define the clinical time course between primary tumor diagnosis and small bowel metastasis detection. A retrospective search of a pathologic database for metastases to small bowel identified 242 cases. Exclusion criteria were cases without CT (N = 49), serosal or mesenteric metastases (N = 114), or cases of direct invasion to small bowel (N = 63). The clinical records and imaging were reviewed for 16 patients. Melanoma was the most common malignancy to metastasize to small bowel (7 of 16 patients). Only one of the 16 cases was detected at the time of initial diagnosis of their primary malignancy. The average time from diagnosis of the primary malignancy or remission to the time of detection of the small bowel metastasis was 7.2 and 8.3 years, respectively. The most common symptoms were gastrointestinal bleeding (N = 5) and small bowel obstruction (N = 5). In 3 cases, the masses were not identified on pre-operative CT. Metastases to the small bowel often occur many years after the initial diagnosis of the primary malignancy or entering remission and may be symptomatic. Attention to the small bowel is particularly importa...Continue Reading

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