Ileocecal adenocarcinoma with intussusception

Case contributed by Michael P Hartung
Diagnosis certain

Presentation

Abdominal pain and concern for mass

Patient Data

Age: 40 years
Gender: Female

Very large ileocolic intussusception with an irregular, lobulated mass at the cecal base. Appendix is dilated but not inflamed. Numerous enlarged ileocolic lymph nodes about the intussusceptum. 

Operation: Right hemicolectomy, mesenteric lymph node resection, primary anastomosis. 

Pathology:

  • Low grade mucinous adenocarcinoma of the cecum invading into the subserosal adipose tissue and appendiceal wall
  • All lymph nodes benign

Case Discussion

Dramatic presentation in a younger patient. However, the differential for an ileocecal mass remains: adenocarcinoma, lymphoma, carcinoid, and GIST.

Amazingly, the lymph nodes were all negative for disease when the hemicolectomy was performed, and were likely enlarged due to congestion and inflammation. 

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