PRIMARY MALIGNANT TUMORS OF THE SMALL INTESTINE: ANALYSIS OF 156 IRANIAN PATIENTS

156 Iranian patients with primary malignant tumors of the small intestine were reviewed. Malignant lymphoma was the most common tumor type, comprising 128 patients (82%), followed by adenocarcinoma (22 patients, 14.1 %), leiomyosarcoma (4 patients, 2.56%) and carcinoid tumor (2 patients, 1.28%). Lymphomas and adenocarcinomas were primarily located in the duodenum or jejunum, whereas leiomyosarcomas were more cornmon in the ileum. Abdominal pain (73%), weight loss (68%), diarrhea (41% ), and nausea or vomiting (35%) were the most common symptoms with these tumors. Among the lymphoma group 95 patients (74.2%) had non-IPSID (immunoproliferative small intestinal disease) lymphoma and 33 patients (25.8%) had IPSID related lymphoma. In contrast to the western world and far east countries in which malignant small intestinal tumors are a disease of middle and old age groups and adenocarcinoma is the most common tumor type, in our area, similar to some other middle east and north African countries, lymphomas are much more frequent. Although Iran is endemic for IPSID related lymphoma, the majority of these tumors are non-IPSID lymphomas and appear in a very young age group (mean age 27 y).