Wu YQ, Wang HY, Shao MM, Xu L, Jiang XY, Guo SJ. Ileal collision tumor associated with gastrointestinal bleeding: A case report and review of literature. World J Gastrointest Surg 2024; 16(2): 628-634 [PMID: PMC10921190 DOI: 10.4240/wjgs.v16.i2.628]
Corresponding Author of This Article
Shao-Ju Guo, Doctor, Chief Physician, Department of Gastroenterology, Shenzhen Traditional Chinese Medicine Hospital, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, No. 1 Fuhua Road, Futian District, Shenzhen 518033, Guangdong Province, China. gsj1080@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Yu-Qi Wu, Hong-Yan Wang, Lin Xu, Xiao-Yan Jiang, Shao-Ju Guo, Department of Gastroenterology, Shenzhen Traditional Chinese Medicine Hospital, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen 518033, Guangdong Province, China
Mu-Min Shao, Department of Pathology, Shenzhen Traditional Chinese Medicine Hospital, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, Shenzhen 518033, Guangdong Province, China
Author contributions: Wu YQ and Wang HY contributed to manuscript writing and editing; Shao MM contributed to pathologic examination; Xu L and Jiang XY contributed to data collection; Guo SJ contributed to conceptualization and supervision; all authors have read and approved the final manuscript.
Supported bythe National Natural Science Foundation of China, No. 82204994; and Sanming Project of Medicine in Shenzhen, No. SZZYSM202211002.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shao-Ju Guo, Doctor, Chief Physician, Department of Gastroenterology, Shenzhen Traditional Chinese Medicine Hospital, The Fourth Clinical Medical College of Guangzhou University of Chinese Medicine, No. 1 Fuhua Road, Futian District, Shenzhen 518033, Guangdong Province, China. gsj1080@163.com
Received: November 22, 2023 Peer-review started: November 22, 2023 First decision: December 11, 2023 Revised: December 27, 2023 Accepted: January 30, 2024 Article in press: January 30, 2024 Published online: February 27, 2024 Processing time: 95 Days and 3.1 Hours
Abstract
BACKGROUND
Collision tumors involving the small intestine, specifically the combination of a hamartomatous tumor and a lipoma, are extremely rare. To our knowledge, no previous case report has described a collision tumor composed of two benign tumors of different origins in the small intestine.
CASE SUMMARY
Here, we present the case of an 82-year-old woman who presented with hemorrhagic shock and was found to have a mass measuring approximately 50 mm × 32 mm × 30 mm in the terminal ileum. Based on computed tomography scan findings, the mass was initially suspected to be a lipoma. A subsequent colonoscopy revealed a pedunculated submucosal elevation consisting of two distinct parts with a visible demarcation line. A biopsy of the upper portion suggested a juvenile polyp (JP). Owing to the patient’s advanced age, multiple comorbidities, and poor surgical tolerance, a modified endoscopic submucosal dissection was performed. Histopathological examination of the excised mucosal mass revealed a lipoma at the base and a JP at the top, demonstrating evidence of rupture and associated bleeding. The patient’s overall health remained satisfactory, with no recurrence of hematochezia during the six-month follow-up period.
CONCLUSION
This case report provides new evidence for the understanding of gastrointestinal collision tumors, emphasizing their diverse clinical presentations and histopathological characteristics. It also offers diagnostic and therapeutic insights as well as an approach for managing benign collision tumors.
Core Tip: Small intestinal collision tumors, specifically those comprising hamartomatous tumors with lipomas, are rare. Most available literature on gastrointestinal collision tumors describes cases with malignant tumor components, and most of these patients are treated surgically. In this report, we present a rare case in which a collision tumor composed of two benign tumors of different origins in the small intestine was accidentally discovered because of hemorrhage-induced hypovolemic shock. Considering the patient’s advanced age, multiple comorbidities, and poor surgical tolerance, we performed a modified endoscopic submucosal dissection procedure. This case demonstrates an approach for managing benign collision tumors in the small intestine.
