Primary Malignant Tumours of the Small Intestine

Background: Primary malignant tumours of the small intestine are rare. These tumours constitute 1-5 of gastrointestinal tract malignancies despite the high rate of epithelial cell turnover and a large mucosal surface area. Clinical; radiological and endoscopic diagnostic difficulties continue to present challenges to surgeons. Primary malignant tumours cause intestinal obstruction necessitating emergency surgery following which diagnosis is made. The consequences of these are significant delay in diagnosis and finding of advanced tumour at surgery. Aim: This study set out to evaluate the management challenges of small intestinal malignancies and proffer solutions for improved outcome. Method : All the cases of primary malignant tumours of the small intestine were retrospectively reviewed for clinical presentation; diagnosis and outcome of treatment and compared with total gastrointestinal malignancies. Result: Seven patients were seen over a 10 - year period. The M: F ratio was 2.5:1 with an age range of 19-55 years and a mean of 43.3 years. The peak age group was in the 4th decade. Small intestinal malignancies accounted for 14.2 of gastrointestinal malignancies during the period of study. Intestinal obstruction was a common mode of presentation with the finding of advanced tumours at surgery. The most common tumour was adenocarcinoma 4(57.1) followed by lymphoma 2(28.6) and 1 case (14.3) of ileal carcinoid. The ileum was the most common site involved 6 (85.7). Conclusion: Malignancies of the small bowel should be considered in patients with recurrent abdominal pain; mass or intestinal obstruction. Aggressive investigation of patients with non specific abdominal symptomatology aimed at tumour localization and histologic diagnosis is important for early diagnosis and treatment for improved outcome

Giant Solitary Hepatocellular Carcinoma. A Case Report

Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver; among indigenous inhabitants of Africa and it may present as solitary or multiple lesions often running a rapidly fatal course. Presented is a case of a 25 year female in apparent general good health with a giant solitary hepatocellular carcinoma. HCC should be considered in the diagnosis of a right upper quadrant/epigastric mass even when it assumes a gigantic proportion in an apparently healthy patient

Small Intestinal Carcinoid Tumour : a Case Report and Review of Relevant Literature

Background : Carcinoid tumours have long been known to be a morphologically distinct class of rare intestinal tumours. The prevalence vary with geographical area; most are clinically silent and are found incidentally at surgery. They may occasionally cause intestinal or vascular obstruction necessitating emergency surgery following which the dia- gnosis is made. We report this first case of intestinal carcinoid seen in this centre in over twenty years. Methods: The case report discussed here is an intestinal carcinoid in- volving the distal ileum. Results:Clinical presentation was recurrent abdominal pain with a tender mass in the periumbilical region extending to the right iliac fossa with noisybowel sounds. Plain abdominal x-ray; barium meal and abdominal Ultrasonography were not diagnostic. A laparatomy on account of intestinal obstruction was performed which revealed a tan yellow tumour extending into the mesentery. Histology revealed carcinoid tumour.Conclusion : Carcinoid tumours should be considered in patients presenting with recurrent abdominal pain or mass or intestinal obstruction. Localization of the tumour is impor- tant since the diagnosis of all carcinoids without systemic features from hormone production depends on the histological structure and staining properties