Colocolic tumoral intussusception in the adult: value of multi-slice
spiral CT imaging
, Hubert Perrin
, Philippe Brunner
, Jean-Noël Bruneton
Service d'Imagerie Médicale, Hôpital Princesse Grace, Monte Carlo, Monaco
Service de la Chirurgie Digéstive, Hôpital Princesse Grace, Monte Carlo, Monaco
Received 20 July 2007; accepted 23 August 2007
Colocolic intussusception in the adult, caused by a tumoral process, is a rare clinical event. We have studied two adults clinically
presenting with a mass in the right iliac fossa, which was produced in one case by a carcinoma involving the right colon and in the other case
involving the sigmoid. Multi-slice spiral CT imaging showed the presence of a colocolic intussusception—the tumoral characteristics of the
lesion eliminated the possibility of a lipoma—and it allowed a satisfactory presurgical evaluation of the pathological process.
© 2007 Elsevier Inc. All rights reserved.
Keywords: Colocolic tumoral intussusception; Multi-slice spiral CT imaging; Adult
In contrast to pediatric pathology, colonic intussusception
is quite rare in the adult age, and in the majority of cases, the
etiology is malignant .
We report two cases of tumoral colocolonic intussuscep-
tion, which occurred in adults, and presenting in both patients
as a palpable mass located in the right iliac fossa. In both
patients, imaging by multi-slice spiral CT (Brilliance 64 Phi-
lips Medical Systems, Eindhoven, The Netherlands) allowed a
multi-planar reconstruction, which led to the correct diagnosis.
2. Case reports
2.1. Case 1
A 53-year-old man came to our observation with a history
of rectal bleeding, anemia by iron deficiency, and abdominal
pain located in the right iliac fossa. The clinical examination
showed a mass in the right iliac fossa; CT abdominal imaging
(Fig. 1A) showed the presence in the cecum of a tumoral
mass measuring 6 cm along its greater axis, which was
intussuscepting into the ascending colon (Fig. 1B), together
with the distal ileum, the arterial, and venous vascular bed
originating from the superior mesenteric (Fig. 1C). Demon-
strated also were lymph nodes, ranging between a few
centimeters and less in size; one was necrotic.
The examination showed no evidence of loco-regional or
farther tumoral extension, and, proximally, there were no
dilated intestinal loops.
At surgery, the cecal tumor was resected and a termino-
lateral ileo-trasverse anastomosis was performed. The histo-
logical diagnosis was of a Lieberkühn's carcinoma, moder-
ately differentiated and infiltrating the subserosa (T3 N1 Mx).
2.2. Case 2
A 67-year-old man presented with a history for the past 2
months of constipation, rectal bleeding, and weight loss of
The physical examination demonstrated a soft-tissue mass
located in the right iliac fossa. A colonoscopy was
Clinical Imaging 31 (2007) 428 – 430
Corresponding author. Service d'Imagerie Médicale, Hôpital Prin-
cesse Grace, 1 avenue Pasteur, 98000 Monte Carlo, Monaco.
E-mail address: firstname.lastname@example.org (A. Cavalleri).
0899-7071/07/$ – see front matter © 2007 Elsevier Inc. All rights reserved.