Ileocolic intussusception - lipoma

Case contributed by Dr Bruno Di Muzio

Presentation

CT IVP for bladder cancer staging. Incidental finding.

Patient Data

Age: 75 years
Gender: Male
CT

CT IVP

There is a tiny 4 mm stone is identified in the inferior pole calyx of the right kidney. After contrast injection, there is prompt contrast excretion from both kidneys. There are no filling defects or dilatation in the bilateral collecting systems. Normal renal enhancement, bilateral simple renal cysts.

The bladder is partially filled with contrast. Suspicious mucosal nodularity in the left lateral wall of the bladder, but no discrete thickened wall or extrinsic mass in the urinary bladder.

Multiple diverticula are identified in the large bowel. There is a fatty mass with intussusception of the terminal ileum in the mid transverse colon. No bowel dilatation to suggest obstruction.

A large low-density mass is identified in the right retroperitoneum, in the posterior pararenal space anterior to the iliacus muscle and lateral aspect of the psoas muscle. It has a smooth border. Thickened wall with a focus of calcification and multiple septa noted. The attenuation of the central aspect of the lesion measures less than 20 HU, suggestive of fluid component.

The imaged solid abdominal organs are otherwise normal. No evidence of free fluid or enlarged lymph nodes.

Case Discussion

Ileocolic intussusception led by a large lipoma

Incidental right iliac fossa extraperitoneal mass was seen on an old scan and negative on PET-CT (Not shown), presumed to be benign, likely hematoma. This was planned to be further followed up on surveillance scans. 

Suspicious nodularity in the left lateral wall of the urinary bladder, probably corresponding to the cystoscopic findings of bladder cancer.

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Case information

rID: 76291
Published: 24th Apr 2020
Last edited: 5th May 2021
Inclusion in quiz mode: Included

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