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Tumor Metastases to the Small Bowel from Extra‐Abdominal Sites

Rarely is the small bowel involved by metastatic lesions emanating from primary tumors in extra-abdominal sites. We have seen 12 such patients at our institution over the past 20 years. None had involvement of the small bowel by direct extension. The primary sites were skin (malignant melanoma), embryonal rhabdomyosarcoma arising in the neck, reticulum cell sarcoma arising on the back, and branchogenic carcinoma. Presenting symptoms were intestinal bleeding, intestinal obstruction, or intestinal perforation. Intestinal resection was performed successfully in nine patients; of these, two are still alive. The longest survivor had bronchogenic carcinoma and is now disease-free eight years after resection of the small bowel metastases. Gastrointestinal bleeding and obstruction may be caused, in rare instances, by metastatic tumors to the small bowel. Surgical resection of these lesions may afford worthwhile palliation and occasional long-term survival.