Ileocecal adenocarcinoma with intussusception
Abdominal pain and concern for mass
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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.
- Low grade mucinous adenocarcinoma of the cecum invading into the subserosal adipose tissue and appendiceal wall
- All lymph nodes benign
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.