Presentation
Abdominal pain and concern for mass
Patient Data
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.