This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
[{'content': 'True about small bowel tumour - \nSelect and explain. \nA. Commonly located in duodenum, B. Lymphoma is common, C. Adenocarcinoma has good prognosis, D. Palliative surgeries are done even in presence of metastasis', 'role': 'user'}, {'content': 'Answer: D \nExplanation: • MC malignant neoplasms of the small bowel: Carcinoid tumors\xa0>adenocarcinomas >malignant GISTs >lymphomas.\n• Adenocarcinomas are more numerous in the proximal small bowel, whereas the other malignant lesions are more common in the distal intestine (ileum).\nClinical Features\n• In contrast to benign lesions, malignant neoplasms almost always produce symptoms\n• MC symptom: Abdominal pain >weight loss\n• Obstruction develops in 15-35% of patients and, in contrast to the intussusception produced by benign lesions, is usually the result of tumor infiltration and adhesions.\n• Diarrhea with tenesmus and passage of large amounts of mucus may occur.\n• Adenocarcinomas may produce the typical constricting apple-core lesions similar to those observed in the colon.\n• Gastrointestinal bleeding is more common with leiomyosarcomas.\n• A palpable mass may be felt in 10-20% of patients, and perforations develop in about 10%, usually secondary to lymphomas and sarcomas.\nDiagnosis\n• Barium meal follow through (BMFT): Accurate diagnosis in 50–70% of patients with malignant neoplasms of the small intestine\n• Enteroclysis (small bowel enema): Diagnostic accuracy of about 90%\nTreatment\n• Wide resection including regional lymph nodes.\n• Often, surgical resection for cure is not possible. Therefore, palliative resection should be performed to prevent further complications of bleeding, obstruction, and perforation.\n• Adjuvant radiation and chemotherapy have little role in the treatment of patients with adenocarcinomas of the small bowel.\nPrognosis\n• Only half of the patients operated on for malignant tumors of the small intestine have lesions amenable to curative resection.\n• One third have a distant metastasis at the time of initial surgery\n• Overall 5-year survival rate after surgical treatment of malignant tumors is only 25%\n• Adenocarcinoma has the poorest prognosis, with an overall survival rate of 15-20%.\n• Obstruction in CA small bowel develops in 15-35% of patients, due to tumor infiltration and adhesions.\n• Obstruction in benign lesions is due to intussusceptions.', 'role': 'assistant'}]