Duodenal Tumor: Causes, Symptoms & Treatment

Duodenal tumor is a tumor of the duodenum that can be benign or malignant. Hereditary genetic predisposition is discussed for duodenal tumors. Treatment is usually equivalent to surgical removal of the tumor.

What is a duodenal tumor?

The duodenum is also known as the duodenum. It is the first short section of the small intestine, which is about 30 centimeters long in the human body. The anatomical structure the edge of the head of the pancreas and is fused to the back wall of the abdominal cavity. In particular, the neutralization of the food pulp acidified in the stomach is one of the tasks of the duodenum. The anatomical structure can be affected by various diseases, which manifest themselves in different symptoms of the gastrointestinal tract. One such disease is duodenal tumor. This term is basically an umbrella term for all tumors of the duodenum. Benign tumors occur less frequently in the duodenum than malignant tumors. Duodenal tumors must be distinguished from benign duodenal ulcers, which affect about two percent of the population. Duodenal tumors belong to the small intestine tumors and are discussed collectively under the clinical picture of small intestine cancer. Colon cancer has a much higher prevalence compared with small bowel and duodenal cancers.

Causes

Different factors play a causative role for duodenal tumors. The exact causes have been largely unexplained for small bowel cancer, but risk factors for small bowel tumors include exposure to harmful foods or substances in the diet. Risk factors also include certain diseases of the intestine. Patients with pre-existing conditions such as Crohn’s disease, a chronic inflammatory bowel disease, are therefore at increased risk of developing a tumor of the small intestine. Peutz-Jeghers syndrome is also classified as a risk factor. Since the syndrome has a hereditary basis, we can speak of genetic risk factors in this context. The small bowel tumors associated with the syndrome are usually benign, but under certain circumstances they can degenerate and in this way become a malignant cancer of the duodenum. There is also an increased risk of small bowel cancers for patients with familial polyposis. These inherited diseases lead to benign polyp formation in the area of the small intestine, including the duodenum, and there is also a risk of degeneration in this context.

Symptoms, complaints, and signs

Patients with duodenal tumors suffer from benign or malignant tumor formation in the duodenum. Malignant duodenal tumors are rare but still occur more frequently in the duodenum than benign variants. Carcinomas usually form in the setting of familial adenomatous polyposis. Sarcomas and gastrointestinal stromal tumors are also conceivable forms. Benign tumors of the duodenum are either Brunneria originating in the Brunner glands or lipomas, adenomas, myomas, and gastrinomas in the setting of Zollinger-Ellison syndrome. Most duodenal tumors do not cause symptoms until late stages. Most often, symptoms are gastrointestinal bleeding that may result in tarry stools. In the setting of duodenal cancer, strictures and stenoses may occur, causing patients more or less severe pain. Symptoms such as nausea or an excessive feeling of fullness may also be relevant to diagnosis. The same applies to complaints such as vomiting. In the course of the disease, a so-called ileus occurs in extreme cases. This intestinal obstruction represents a life-threatening complication and requires immediate intervention.

Diagnosis and course

The suspected diagnosis of duodenal tumor is made on the basis of the patient’s history and initial physical examination. Some duodenal tumors can be palpated through the creek ceiling in slender individuals. X-ray examinations with contrast medium, ultrasound, laparoscopy, computed tomography, magnetic resonance imaging or gastrointestinal endoscopy are performed to confirm the diagnosis. In addition, a biopsy of the tumors is ordered as part of the diagnostic process to provide evidence of the malignancy of the growths. For patients with duodenal tumor, the prognosis depends on the malignancy of the tumor. In addition, the timing of diagnosis and the presence of complications play a prognostically crucial role.

Complications

In most cases, duodenal tumor is removed by surgery so that the patient does not experience further discomfort or complications. In this case, the further development of the disease depends largely on the type and spread of the tumor. The affected person suffers from discomfort in the stomach and abdominal region. Diarrhea and vomiting occur. It is not uncommon for flatulence and a permanent feeling of fullness to occur as well. The patient’s quality of life is greatly reduced by the duodenal tumor. In the worst case, complete intestinal obstruction can occur if the tumor is not treated. This can also be fatal for the patient. Since a diagnosis can be made relatively easily, early treatment is also possible. If the tumor is benign, it does not necessarily have to be removed. This is especially true if the patient does not complain of symptoms. As a rule, a benign tumor is also only detected by chance. In the case of a malignant tumor, surgery must be performed. Afterwards, the affected person often has to undergo radiation therapy in order to avoid consequential damage and complications. With early and proper treatment, there are no further complications and life expectancy is not reduced.

When should you see a doctor?

Because duodenal tumors do not cause symptoms until late stages, early diagnosis of the disease proves difficult. It is therefore advisable to go regularly for colorectal cancer screening – especially at an advanced age and with any risk factors, this is important. In addition, a doctor should be consulted if severe pain, a feeling of pressure in the area of the lower stomach or an excessive feeling of fullness suddenly occur. In the further course, symptoms such as vomiting and a general feeling of illness may be added, which should also be clarified quickly. If there are signs of intestinal obstruction, the emergency physician must be called in immediately. In the event of severe circulatory problems or even circulatory collapse, first aid must also be administered until the doctor arrives. Depending on how far the duodenal tumor has progressed, a longer hospital stay may subsequently be required. Those affected should also talk to a nutritionist, as an unhealthy lifestyle is often at the root of the symptoms. Which measures are useful in detail, however, can only be answered by the responsible physician.

Treatment and therapy

Duodenal tumors are ideally treated causally. This means that the symptoms are addressed at their cause. Benign tumors of the duodenum do not necessarily need to be removed. However, there is an indication for an invasive surgical treatment procedure as soon as complications such as bleeding or narrowing develop. Before such complications occur, patients with benign duodenal tumors are usually observed. A life-threatening risk does not usually arise from benign duodenal cancers. Nevertheless, regular check-ups are indicated to detect possible degeneration of the tumors as early as possible. Malignant duodenal tumors require surgical intervention as soon as possible. In addition to surgical removal of the tumor, options such as radiation therapy and chemotherapy are available for treatment. In most cases, these measures accompany the surgical steps. Surgical intervention is usually always sought for malignant tumors. Removal of the tumor-affected entire intestinal segment with including a centimeter safety margin is indicated as part of surgery. Supportive radiotherapy acts directly on the tumor region. Chemotherapy, unlike radiation therapy, also counteracts scattered and spread cancer cells. Since duodenal tumors cause pain to a greater or lesser degree in many cases, supportive therapy is also offered in individual cases to relieve patients’ pain. An increase in the quality of life is the focus of this measure. Conservative drug therapies with analgesics should be considered as pain therapy, such as the administration of morphine in cases of severe pain.

Outlook and prognosis

The prognosis of duodenal tumor is particularly dependent on whether it is benign or malignant. The best prognosis is given to patients suffering from a benign tumor at an early stage.If there are no further complaints, treatment does not necessarily have to be initiated. The patient is asked to participate in control examinations and to consult a physician if symptoms occur. If growth or other changes in the duodenal tumor are noticed in the further course, treatment is initiated. If the values remain constant, the patient can live a good and normal life with the tumor for the rest of his life. Larger benign duodenal tumors that lead to further symptoms are removed in a surgical procedure. Afterwards, the patient usually recovers within a short period of time. In the case of malignant tissue changes, the good prognosis changes. The larger the diagnosed tumor and the older the affected person, the less favorable the prospects for recovery. Bowel function is impaired and can lead to organ failure. This represents a life-threatening condition. In the worst case, cancer cells detach from the tumor and are transported via the blood to other sites in the organism. Metastases can form there and new cancers develop. The risk of a shortened life expectancy thus increases.

Prevention

The causes of duodenal tumors have not yet been conclusively determined. Hereditary causes are suggested and have been documented for various risk factors of the phenomenon. Because of the presumed genetic predisposition, duodenal tumor can hardly be prevented other than by genetic counseling during the family planning phase.

Follow-up

In most cases of duodenal tumor, the measures of follow-up are severely limited. First and foremost, this tumor must be detected relatively early to prevent it from spreading and to prevent further complications and discomfort. In general, early diagnosis always has a positive effect on the further course of the tumor and can prevent further complications. As a rule, the earlier the tumor is detected, the better its further course. Even after successful removal of the duodenal tumor, regular examinations of the intestine should be performed in order to detect and also remove other diseases and further tumors. Since the duodenal tumor is usually treated by surgery, the affected person should in any case rest and take care of the body after such an operation. The affected person is usually also dependent on the help and support of friends and relatives, and psychological support is also very important. A healthy lifestyle with a healthy diet can also alleviate the symptoms. In most cases, a duodenal tumor reduces the life expectancy of the affected person.

What you can do yourself

Although a tumor in the duodenum is often benign, the disorder should definitely be taken seriously. As soon as the affected person observes symptoms, a doctor must be consulted immediately. Treatment usually consists of surgical removal of the tumor. The patient cannot help himself in this case. However, he can take preventive measures. Unless the ulcer is surgically removed, it is necessary to monitor the disorder, since even a benign tumor can become malignant. The patient’s chances of survival then depend greatly on how early this change is noticed and treated. Preventive examinations recommended by the treating physician should therefore be observed without fail. If new symptoms occur, these should never be played down, but the doctor should always be consulted immediately. Even if the tumor is not malignant, delayed treatment can lead to significant complications, such as intestinal obstruction. In the case of a malignant duodenal tumor, radiation therapy or chemotherapy is usually required in addition to surgery. The latter in particular is often accompanied by enormously distressing side effects. However, patients must not discontinue these treatments on their own initiative. If the cancer comes back, the patient’s life is regularly in danger. Intestinal tumors can also often be positively influenced by a change in diet. Patients should seek the support of a nutritionist in developing a disease-specific diet.