Almeida MCM, Rey LL, Carvalho APS, Artigiani NR, Gomes LL, Grande JC

Language: English
References: 9
Page: 47-50
PDF size: 63.18 Kb.

ABSTRACT

Objective: The authors present a rare manifestations of stromal tumors; an ileal tumor leading to intussusception. Material and methods: (Case report), a 39 years old female patient: Present colycky abdominal pain and constipation for 15 days; seven days prior to the admission she had a single episode of diarrhea with blood, physical examination reveled mild pallor; an abdominal mass measuring 10 cm at the right flank. Plain abdominal x-ray demonstrated a soft tissue mass effect and atypical absence of gas at the right flank. Ct scanning was performed, revealing thickening of the right colon and an image of concentric layers, highly suggestive of intussusception, barium enema confirmed the diagnosis. Treatment: Exploratory laparotomy was performed and surgical findings were compatible with ileocolic intussusception, a right colectomy with resection of the invaginatedilium was done followed by primary anastomosis. Results: Histopathological studies confirmed a 2.4 cm gastro-intestinal stromal tumor (gist), 21 cm from the ileocecal valve compromising only the submucosae. Immunohistochemical test were positive for CD 117 (C-KIT), CD 34, 1a4 and vimentin. Mitotic rate was lower than 5/50 high-power fields (HPF). Discussion: Intussusception occurs rarely in adults (less than 5%) and is responsible for only 1% of the all cases of the obstruction in this group, in 95% of occurrences, etiology is identifiable. Symptoms are related to the location of the tumor. Gastric lesions more often present with bleeding (60-70%).

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