Adult ileocolic intussusception secondary to a submucosal cecal lipoma

Triantopoulou, C.; Vassilaki, A.; Filippou, Dimitrios; Velonakis, S.; Dervenis, Christos; Koulentianos, E.

doi:10.1007/s00261-003-0137-4

Cited by 27 publications

(26 citation statements)

References 11 publications

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“…The spiculated appearance of the surface of the mass may be due to inflamed and/or ulcerated lipomatous tissue. Large lipomas associated with intussusception have been rarely reported, but nearly all of these produced an ileocolonic intussusception and rarely mimicked malignancy, making our case even more unusual [10][11][12][13]. …”

Section: To the Editorsmentioning

confidence: 99%

Large Colonic Lipoma Mimicking Colon Cancer and Causing Colonic Intussusception

2008

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To the Editors:Large lipomas in the left colon are a rare entity, and those that are seen usually have a classic, benign appearance. We describe a patient with a large, left-sided, lipoma that mimicked an adenocarcinoma and produced a partial intussusception as well.A 69-year-old previously healthy man presented with a 1-month history of hematochezia and a 10-lb weight loss. The patient denied any changes in bowel movement frequency; he continued to average 1-2 bowel movements per day. He denied abdominal pain, nausea, or vomiting. Previous medical history included an appendectomy and hernia repair. The patient took no medications and denied any behavioral risk factors. Family history revealed a daughter with ulcerative colitis, and no colorectal cancer.Physical examination was unremarkable. The complete blood count and the basic metabolic panel were normal. Computed tomography (CT) revealed a mass in the descending colon, with partial intussusception involving the sigmoid colon, interpreted as a likely adenocarcinoma. There was no adenopathy or evidence of metastases. Colonoscopy revealed a 7-cm, ulcerated, fungating, mass on a thick stalk, with partial intussusception just distal to the splenic flexure ( Fig. 1). Biopsies of the mass only revealed benign inflammation without malignant tissue.Because of the appearance of the lesion and the negative findings of biopsies, a repeat colonoscopy was performed. After careful evaluation, the lesion was felt to be removable via endoscopic means alone. The lesion was removed with a large snare and electrocautery in a single piece. There were no complications. Pathology revealed a 7-cm inflamed and ulcerated lipoma, with no evidence of malignancy. The patient has done well thereafter.This case demonstrates how, on rare occasions, large colonic lipomas and malignancies can be difficult to differentiate prior to resection. With regards to symptoms and endoscopic appearance, the two can be indistinguishable. Even with abdominal imaging and direct colonoscopic visualization, lipomas can imitate carcinomas.Despite being the third most common benign tumor of the colon, colonic lipomas are comparatively rare [1], with a reported incidence less than 5% [2, 3]. Colonic lipomas are positively correlated with distance from the anus. Unlike that in our patient, almost half are found in the ascending colon [4].Colonic lipomas are most frequently small and asymptomatic [5]. Only one-quarter of all lipomas are symptomatic [6], and those symptomatic lipomas are generally larger than 2 cm, as was the case in our patient. Symptoms can include obstruction, bleeding, or, very rarely, intussusception, as was seen in our patient [2,3].With barium enema, lipomas most often appear as ovoid, well-demarcated, filling defects. By the application of external pressure to the abdomen, or with physiological peristalsis, a ''squeeze-sign''-a change in the appearance of the filling defect-can sometimes be elicited. On CT scan, lipomas also typically appear ovoid, with well-defined margins, and with absor...

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Section: To the Editorsmentioning

confidence: 99%

Large Colonic Lipoma Mimicking Colon Cancer and Causing Colonic Intussusception

2008

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“…Barium studies can demonstrate classic "coil spring" sign at the point of intussusception. 1 Colonoscopy on the other hand has been reported to be useful for both diagsosis and treatment of such cases in the form of reduction of intussusception and snaring of the polyp. But there is a significant risk of perforation, and in all cases consent of laparotomy should be taken prior to procedure.…”

Section: Discussionmentioning

confidence: 99%

“…1 Of all intussusception cases only 6% 2 occur in adult and most of them are in the right colon.Unlike pediatric cases 80% 3 of adult intussusception has a pathologic lead point. Adenomatous polyp, adenocarcinoma, lymphoma, leomyosarcoma, and rarely lipoma are responsible 4,5 in colocolic intussusception.…”

Section: Introductionmentioning

confidence: 99%

Intussuscepted Sigmoid Colonic Lipoma Mimicking Carcinoma Rectum

2016

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Adult colorectal intussusception is a relatively rare condition. It is different from that of a child in that, most cases have an organic etiology like a malignant or benign neoplasm. This is a 40 year female patient presenting with passage of blood and mucous per rectum later diagnosed as sigmoidorectal intussusception due to submucous lipoma in sigmoid colon that was protruding through anus giving the appearance of a large polypoid rectal growth.

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“…Erişkinlerde görülen intestinal invajinasyonlar, genelde ince bağırsağın malign tümör-lerine sekonder gelişmektedir (5,6). Her iki cinsiyette de benzer oranlarda ve sıklıkla 6 ile 7. dekatlar arasında görülür (3,4 (2).…”

Section: Discussionunclassified

Intestinal Non-Hodgkin Lyphoma causing ileocaecal invagination: a case report

Kaya¹,

Kızıltan²,

Sit³

et al. 2012

Turk J Bioch

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Abstractİnvajinasyon, bağırsağın birbirini takip eden iki segmentin, birbirinin içine girmesidir. Acile karın ağrısı ile başvuran 31 yaşında bayan hastanın batın grafisinde yer yer hava-sıvı seviyeleri izlenmesi üzerine çekilen abdominal bilgisayarlı tomografide transvers kolon düzeyinden başlayıp, çekuma kadar uzanım gösteren kitle ve invajine barsak segmenti izlendi. Kitlenin histopatolojik inceleme sonucu non-hodgkin lenfoma olarak değerlendirildi. Erişkinlerde görülen intestinal invajinasyon olguları, ince bağırsağın malign tümörlerine bağlı oluşabilmektedir. Bu sebeple, intestinal invajinasyona sebep olan kitlenin çıkarılmasında, yapılacak rezeksiyonun sınırlarının biraz daha geniş tutulması düşünülebilir.Invagination is getting into each other of two consecutive intestinal segments. A 31 year old female admitted to emergency department with abdominal pain, x-ray of the abdomen revealed occasional air -fluid levels. Abdominal Computed Tomography scan performed and it showed a mass in transvers colon elongated to caecum and invaginated bowel segments. Histopathological evaluation of the mass revealed non hodgkin lymphoma. Intestinal invaginations in adults are mostly caused of malign tumors of the intestine. Therefore, a wider excision of the mass caused invagination should be considered.Anahtar Kelimeler: İnvajinasyon, non hodgkin lenfoma, malign tümör.

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Adult ileocolic intussusception secondary to a submucosal cecal lipoma

Cited by 27 publications

References 11 publications

Large Colonic Lipoma Mimicking Colon Cancer and Causing Colonic Intussusception

Large Colonic Lipoma Mimicking Colon Cancer and Causing Colonic Intussusception

Intussuscepted Sigmoid Colonic Lipoma Mimicking Carcinoma Rectum

Intestinal Non-Hodgkin Lyphoma causing ileocaecal invagination: a case report

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