A CASE OF CARCINOMA OF THE ILEUM ASSOCIATED WITH INTUSSUSCEPTION

Primary carcinoma of the ileum is a relatively uncommon disease. We have recently encountered a case of primary carcinoma of the ileum associated with intussusception, which is presented here with a review of 18 cases reported in Japan in the past 10 years.The patient, a 73-year old woman, was admitted to our hospital with the chief complaint of abdominal fullness. Ultrasonography revealed a tumor associated with intussusception. Barium enema examination showed a tumor in the caecum. It was diagnosed as intussusception at the ileocaecal region by an upper gastrointestinal series. At surgery a Borrman type 1 tumor (4.5×3.5 cm), which is associated with intussusception into the ascending colon, was identified in the ileum 8 cm from Bauhin's valve. The resected tumor was histologically diagnosed as well-differentiated adenocarcinoma with no metastasis in the regional lymph nodes.Carcinomas of the ileum usually occur in patients between 50 and 70 years old and predominate in men. Their rarity and nonspecific presenting features make their diagnosis difficult to establish. In the 18 cases we reviewed, they were often diagnosed as ileus. The tumors were within 30 cm from Bauhin's valve in 15 of the cases; the diameter was more than 4 cm and the shape was polypoidal in many cases. Most adenocarcinomas were well differentiated.