Abstract
BackgroundGastrointestinal stromal tumors are mesenchymal tumors of the gastrointestinal tract of varying malignant potential that are believed to originate from neoplastic transformation of the interstitial cells of Cajal. They may occur anywhere along the gastrointestinal tract, but most commonly arise in the stomach or small intestine. They usually grow exophytically invading adjacent organs or perforating into the peritoneal cavity. They may also cause bleeding or obstructive symptoms. Intussusception and obstruction is a very uncommon presentation of these lesions because of their tendency to grow in an exraluminal fashion.Case presentationWe present an unusual case of ileoileal intussusception in a 79-year-old female patient caused by a gastrointestinal stromal tumor located in the terminal ileum, and review the diagnostic and therapeutic approach highlighting the difficulty in diagnosing this entity preoperatively as a cause for intestinal obstruction.ConclusionThis case presents an unusual malignant cause of adult intussusception and highlights the importance of computed tomography scanning in the accurate diagnosis of this rare entity.
Highlights
Gastrointestinal stromal tumors are mesenchymal tumors of the gastrointestinal tract of varying malignant potential that are believed to originate from neoplastic transformation of the interstitial cells of Cajal
Adult intussusception represents only about 1% to 5% of all cases of intestinal obstructions and is commonly caused by a lesion acting as the apex of intussusception [4]
We present an unusual case of ileoileal intussusception in a 79-year-old female patient caused by a Gastrointestinal stromal tumors (GISTs) located in the terminal ileum, acting as the apex of intussusception, and review the diagnostic and therapeutic approach high
Summary
Gastrointestinal stromal tumors (GISTs) are the least common of small intestinal malignant neoplasms, with an annual incidence of 1.2 cases per million population [1,2,3]. Computed tomographic (CT) scan of the abdomen with oral contrast showed the "target" sign of intussusception in the right lower quadrant of the abdomen (Figure 1), following the CT scan, the patient's pain and abdominal distension deteriorated and led to an emergent exploratory laparotomy. This revealed an ileoileal intussusception (Figure 2) secondary to a 2.2 × 1.8 × 2 cm intramural mass in the terminal ileum, located 20 cm proximal to the ileocecal valve (Figure 3). The tumor was estimated to have an intermediate malignant potential and the patient is under surveillance according to the guidelines of the European Society of Medical Oncology [5]
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