血管造影にて腫瘍濃染様所見を呈した回腸末端部脂肪腫による腸重積の1例

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A case of 81-year-old Japanese male with Ileocecal intussusception due to an ileal lipoma which revealed a tumorstain-like appearance in angiography is reported. The patient complained o abdominal fullness for 3 months. Barium enema and colonoscopy revealed an egg-sized tumor in the ascending colon. The tumor seemed to be continued with terminal ileal mucosa and prolapsed into the ascending colon. The tumor showed a round low density area approximately 3 cm in diameter by computed tomography and it also showed a hyperechoic shadow by ultrasonographic examination. Ultrasonography also revealed a multiple concentric ring sign adjacent to the tumor in the right lower abdominal scanning. From the above results, the tumor was first diagnosed a lipoma with intussusception. However, angiography revealed a tumorstain-like appearance in the venous phase. Because of these findings, we could not deny a malignant tumor, considering the case for the operative indication. The operative specimen revealed a benign lipoma (4.5×3.0×3.0cm) located in the ileum, 10 cm proximal to the ileocecal valve. As for the tumorstain-like appearance we speculated that it was derived from the difference of angiographic staining between ileum and colon, as well as due to an inflammatory change of the surface mucosa.
日本大腸肛門病学会の論文