Small intestine: neoplasia

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Sections available in full article Introduction, Presenting signs, Age predisposition, Breed predisposition, Pathogenesis, Etiology, Predisposing factors, Pathophysiology, Timecourse (incubation, duration), Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Gross autopsy findings, Histopathology findings, Differential diagnosis, Treatment, Standard treatment, Sequelae, Prognosis, Expected response to treatment, Reasons for treatment failure, Sources, Publications, Vetstream contributor(s),
Contributors Dr Susan North BSc PhD DVM DACVIM(Onc)
Dr William Brewer Jr DVM DiplACVIM Oncology and Internal Medicine

Introduction

  • Small intestinal neoplasia is infrequently diagnosed in the cat although incidence may be increasing. They represent approximately 1% of all feline malignancies.
  • Most common tumor is lymphosarcoma (LSA), followed by mast cell tumor (MCT) and adenocarcinoma.
  • Rare tumors include sarcoma and carcinoids.
  • Signs : weight loss, inappetence, or weight loss with a voracious appetite, vomiting or diarrhea, melena.
  • Diagnosis : diagnostic imaging, exploratory surgery, biopsy and histopathology.
  • Treatment : surgery +/- chemotherapy depending on biopsy.
  • Prognosis : depends on type of tumor; poor to guarded.

Diagnosis

Clinical signs

  • Palpable mid-abdominal mass.
  • Palpably thickened 'ropey' intestine.
  • Ascites in advanced disease  Ascites 01: whole cat  .

Diagnosis

Differential diagnosis

  • Inflammatory bowel disease (IBD)  Inflammatory bowel disease: overview  .
  • Diffuse intestinal disease.
  • Small intestinal foreign body  Intestine: foreign body - linear  .
  • Small intestinal obstruction  Intestine: obstruction  .
  • Small intestinal intussusception  Intussusception  .
  • Hyperthyroidism  Hyperthyroidism  .

Sequelae

Prognosis

  • LSA: 8-10 months median survival with doxorubicin  Doxorubicin  .
  • MCT: 2-3 months; 12-14 months with splenectomy  Splenectomy  .
  • Adenocarcinoma: approximately 1 year (range 1-50 months); often diagnosed late in disease course and metastasis common. Carcinomatosis is a possible sequela.

Expected response to treatment

  • Weight gain.
  • Cessation of clinical signs.

Reasons for treatment failure

  • Incomplete resection.
  • Metastases.
  • Drug resistance.
  • Risk of gastrointestinal perforation following chemotherapy: only seen infrequently with extensive disease.

Sources

Publications

Refereed papers

  • Barrand K R & Scudamore C L (1999)Intestinal leiomyosarcoma in a cat.JSAP.40, 216-219.
  • Howl J H & Peterson M G (1998)Intestinal mast cell tumor in a cat - presentation as eosinophilic enteritis.JAAHA31, 457-461.
  • Zwahlen C H, Lucrovy M D, Kraegel S A & Madewell B R (1998)Results of chemotherapy for cats with alimentary malignant lymphoma - 21 cases (1993-1997).JAVMA213, 1144-1149.
  • Mahoney D M, Moore A S, Cotter S M, Engler S J, Brown D & Penninck D G (1995)Alimentary lymphoma in cats - 28 cases (1988-1993).JAVMA207, 1593-1598.

Other sources of information

  • Graham J CCurrent concepts in gastrointestinal neoplasia.In:Consultations in feline internal medicine.Chapter 14 pp 99-103.

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