Small Bowel Intussusception Secondary to Metastatic Spindle Cell Sarcoma: A Case Report and Review of the Literature

Abstract

Background: Intussusception is an uncommon diagnosis in adults. It is characterized by an abnormal luminal "lead point" that precipitates bowel invagination, resulting in obstructive symptoms that warrants further investigation. Both benign and malignant tumors have been reported to cause small bowel intussusception, with primary small bowel malignancies occurring more commonly. We present an unusual case of a middle-aged gentleman with small bowel intussusception and obstruction caused by a metastatic spindle cell sarcoma and a review of the available literature.Case Presentation: A 50-year-old male patient with a history of recurrent spindle cell sarcoma of the scalp treated 3 years prior presented with abdominal pain and bloating. Diagnostic workup revealed two segments of small bowel intussusception and obstruction as well as several lung nodules. The patient underwent exploratory laparotomy for resection and primary anastomosis of the intussuscepted segments of small bowel. Histologic analysis of the surgical specimens confirmed metastatic spindle cell sarcoma. After completion of full metastatic workup, patient was counseled on the diagnosis and offered palliative chemotherapy while awaiting results from tumor molecular profiling to guide future treatment and clinical trial options. Conclusion:Intussusception in the adult patient should be carefully evaluated, with a high suspicion for malignancy as the underlying cause, especially in those with a personal history of cancer.