A Case of Rectal Intussusception due to Type2 Rectal Cancer in an Adult

Abstract

A 78-year-old Japanese man was referred to our surgical department for further investigation of anemia and bloody stool during his orthopedic hospitalization due to fracture of the right femur. An abdominal CT scan showed multiple concentric ring sign in the lower rectum. In addition, a rectal tumor was found by colonoscopy. Rectal intussusception due to rectal cancer was diagnosed. No ischemic changes were seen in the rectum and we employed elective surgery. At surgery we identified the intussusception not to be reduced and performed resection of the lower rectum including the intussuscepted portion with colostomy. Macroscopic specimen revealed a type 2 rectal tumor which included moderately differentiated adenocarcinoma histologically (Ra, type 2, 60×35 mm, tub2, pT3, INFb, ly1, v1, pN0 (0/14), pRM0, pDM0, and pStage II). Unlike intussusception in children, adult onset intussusception, especially rectal involvement caused by type 2 rectal cancer, is very rare. So far only five adult cases of rectal intussusception due to type 2 rectal cancer, including our case, have been reported in the Japanese literature.