Intussusception as the Primary Presentation of a Cecal Tumor

TL;DR

A 74-year-old woman with abdominal pain was found to have a cecal tumor causing intussusception, leading to surgery and cancer diagnosis.

Contribution

This case highlights intussusception as an unusual initial presentation of a cecal tumor.

Findings

The patient's cecal mass was identified as mucinous adenocarcinoma.

No metastatic disease was found in 14 retrieved lymph nodes.

The patient is undergoing active surveillance post-surgery.

Abstract

We report the case of a 74-year-old female patient who had experienced intermittent abdominal pain over the previous three months. She presented to the emergency department with worsening symptoms and was admitted with a diagnosis of intestinal obstruction. Imaging revealed a colocolic intussusception, with a cecal mass serving as the lead point. Considering the possibility of malignancy, the patient underwent a right hemicolectomy, during which the intussuscepted segment was excised. Pathologic examination confirmed a cecal mucinous adenocarcinoma. Fourteen lymph nodes were retrieved in the surgical specimen, with no evidence of metastatic disease. The patient was placed on an active surveillance regimen, including clinical examinations every three months, thorax, abdominal, and pelvic CT scans at six months, and a total colonoscopy within the first postoperative year.

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