Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 26, 2020; 8(10): 2044-2049
Published online May 26, 2020. doi: 10.12998/wjcc.v8.i10.2044
Ileocecal intussusception caused by two different tumors - which is the culprit lesion? A case report
Wu-Feng Fan, Gang Ma, Gui-Chen Li, Jin Long, Yuan-Hong Xu, Ke-Jian Guo, Zhe Liu
Wu-Feng Fan, Gang Ma, Gui-Chen Li, Jin Long, Yuan-Hong Xu, Ke-Jian Guo, Zhe Liu, Department of Pancreatic-Biliary Surgery, First Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
Author contributions: All authors contributed to the acquisition of data and writing and revision of the manuscript.
Supported by the National Natural Science Foundation of China, No. 81572360; and the Liaoning Provincial Department of Education Science Research Project, No. L2014299.
Informed consent statement: The patient involved in this study gave his written informed consent authorizing use and disclosure of his protected health information.
Conflict-of-interest statement: The authors declare no conflicts of interest.
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: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Liu Zhe, MD, Assistant Professor, Doctor, Surgeon, Department of Pancreatic-Biliary Surgery, First Hospital of China Medical University, No.155 Nanjing North Street, Heping District, Shenyang 110001, Liaoning Province, China. liuzhecmu@126.com
Received: January 21, 2020
Peer-review started: January 21, 2020
First decision: February 26, 2020
Revised: April 1, 2020
Accepted: April 15, 2020
Article in press: April 15, 2020
Published online: May 26, 2020
Abstract
BACKGROUND

Ileocecal intussusception caused by two different tumors is rare, according to a literature review. We describe a case of a male patient with a cauliflower-like mass in the middle of the transverse colon observed by colonoscopy before surgery. It was considered to be intussusception caused by colon cancer. However, a substantial lipomatous mass was seen in the distal end of the intussusception by computed tomography before surgery, which posed a challenge in the preoperative diagnosis.

CASE SUMMARY

We report a 72-year-old male patient with intussusception. The patient underwent right hemicolectomy and cholecystectomy in our hospital on April 29, 2019. During operation, the ileum was inserted into the ascending colon by about 15 cm, and a tumor with a diameter of approximately 3.0 cm was observed in the distal part of the intestine. An atypical liposarcoma/highly differentiated liposarcoma in the adipose tissue was suspected in the postoperative pathology, and a lipoma was diagnosed after MDM2 gene testing. A 4.0 cm × 5.0 cm polypoid mass was seen immediately adjacent to the mass, and the postoperative pathology report suggested a high-level tubular adenoma. The patient was eventually cured and discharged with an uneventful follow-up.

CONCLUSION

Intussusception caused by two different types of masses is extremely rare. At present, surgery is the best treatment once intussusception is diagnosed.

Keywords: Adult intussusception, Two different tumors, Right hemicolectomy and cholecystectomy, Atypical liposarcoma, High-level tubular adenoma, Case report

Core tip: Ileocecal intussusception caused by two different tumors is rare. We report a 72-year-old male with intussusception. A cauliflower-like mass was observed in the transverse colon by colonoscopy before surgery. It was considered to be intussusception caused by colon cancer. However, a substantial lipomatous mass was seen in the distal end of the intussusception by computed tomography before surgery. The patient underwent a right hemicolectomy and cholecystectomy in our hospital. The benign and malignant fatty masses were sent for microscopic/immunohistochemical examination and MDM2 fluorescence in situ hybridization diagnosis after surgery. The patient was eventually cured and discharged with an uneventful follow-up.