Small Bowel Tumours

The small bowel is the long section of intestine between the stomach and the colon. Tumours here are rare compared with bowel cancer. The main types are neuroendocrine tumours, gastrointestinal stromal tumours (GISTs), adenocarcinoma and lymphoma. Some benign growths and polyps also occur, particularly in people with inherited polyp syndromes.

Symptoms are often vague and may include intermittent abdominal pain, bloating, nausea, weight loss, anaemia or bleeding. Some tumours cause a blockage of the bowel and are found urgently.

Because the small bowel is difficult to reach with a standard endoscope, diagnosis relies on CT or MRI scans, sometimes with specialised CT enterography, and on capsule endoscopy or balloon enteroscopy where a biopsy is needed. Neuroendocrine tumours may be investigated with specific blood tests and PET scans. All patients are discussed at a multidisciplinary team meeting.

For most small bowel tumours, surgery to remove the affected segment of bowel and its lymph nodes is the main treatment, usually performed laparoscopically or robotically where safe. GISTs are removed without needing to take the lymph nodes and may be treated with targeted medication before or after surgery. Lymphoma is generally treated with chemotherapy rather than surgery.

We work closely with medical oncology colleagues, so decisions about chemotherapy, targeted therapy or other treatments are made together with your surgeon.

Follow-up depends on the type of tumour and may include regular scans and blood tests over several years. Neuroendocrine tumours in particular are often slow growing and benefit from long-term specialist surveillance.