Wong L, Kanthasamy SV, Durairaj G, Thangaratnam RR. Neuroendocrine tumour masquerading as intussusception: A case report.
Int J Surg Case Rep 2020;
77:48-52. [PMID:
33137672 PMCID:
PMC7610031 DOI:
10.1016/j.ijscr.2020.10.091]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/20/2020] [Accepted: 10/20/2020] [Indexed: 12/13/2022] Open
Abstract
Intussusception commonly occurs in the paediatric population.
Presentation in the adult population is likely malignant.
It is important for an intussusception to be managed surgically in adults.
Neuroendocrine tumour can present as intussusception in the adult population.
Resection with lymph node clearance is needed for complete staging.
Introduction
Intussusception usually occurs in the paediatric population. When it occurs in the adult population, it is normally caused by a malignant intraluminal pathology.
Presentation of case
A 72-year-old female presented to us with right-sided abdominal pain for 3 weeks, associated with vomiting and diarrhoea. She had an appendectomy done 30 years ago and a recent myocardial infarction. Abdominal examination revealed a previous appendectomy scar and tenderness over the right lumbar region. Computed tomography showed ileocaecal intussusception. Right hemicolectomy with a double barrel stoma was performed as she was unstable intraoperatively. Histopathological examination of the tumour showed a well-differentiated neuroendocrine tumour. Subsequent PET scan showed no systemic disease and a reversal of the stoma was done. She remained disease free for a year.
Discussion
Our patient had undergone a right hemicolectomy despite the high risk of mortality, as there is a high chance of malignancy. Double barrel stoma was done, as she was unstable intraoperatively. Fortunately, she recovered well and had her stoma reversed without any further recurrence of her disease.
Conclusion
Adult patients who present with intussusception should be managed with resection, as there is a high possibility of a malignancy. Early resection should be planned to prevent further spread of the tumour.
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