Case Report - Masquerading doughnut: a case of misdiagnosed ileocecal tumor-induced intussusception

Sep 28, 2026

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Adult intussusception is rare and often linked to an underlying pathology such as tumors, but its coexistence with colorectal cancer in young patients creates major diagnostic dilemmas. A 21-year-old man presented with progressive right upper and central abdominal pain. CT suggested ileocecal intussusception due to lipoma with a separate transverse colon mass. Emergency surgery confirmed a single 4.0×5.0 cm cauliflower-like ileocecal adenocarcinoma driving intussusception and mimicking synchronous lesions, highlighting limitations of imaging and diagnostic vigilance for malignancy.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages7

Reading Time18 min

AccessFree to download

Background/introduction

Case presentation

Clinical presentation and investigations

Imaging findings and surgical exploration

Conclusions

TYPE Case Report PUBLISHED 19 December 2025 DOI 10.3389/fonc.2025.1716593 OPEN ACCESS EDITED BY Andrea Balla, Virgen Macarena University Hospital, Spain REVIEWED BY Mahmoud Othman, University of Balamand, Lebanon Biro Ede, Pe´cs University, Hungary *CORRESPONDENCE Guolin Zhang [zhangguolin@zju.edu.cn](zhangguolin@zju.edu.cn) RECEIVED 24 October 2025 REVISED 29 November 2025 ACCEPTED 30 November 2025 PUBLISHED 19 December 2025 CITATION Xu C, Zhu R, Dai Q, Xu G and Zhang G (2025) Case Report: Masquerading doughnut: a case of misdiagnosed ileocecal tumor-induced intussusception. Front. Oncol. 15:1716593 . doi: 10.3389/fonc.2025.1716593 COPYRIGHT © 2025 Xu, Zhu, Dai, Xu and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Case Report: Masquerading doughnut: a case of misdiagnosed ileocecal tumor-induced intussusception Chuchu Xu 1,2, Renjun Zhu 2,3, Qingfeng Dai 4, Guangen Xu 1,2 and Guolin Zhang 1,2* 1 Department of Gastrointestinal Surgery, Shaoxing People’s Hospital (The First Hospital of Shaoxing University), Shaoxing, Zhejiang, China, 2School of Medicine, Shaoxing University, Shaoxing, Zhejiang, China, 3 Department of Emergency, Shaoxing People’s Hospital (The First Hospital of Shaoxing University), Shaoxing, Zhejiang, China, 4Zhijiang College, Zhejiang University of Technology, Shaoxing, Zhejiang, China Background: Intussusception in adults is rare and is often associated with an underlying pathology such as tumors. Its coexistence with colorectal cancer (CRC) in young patients presents unique diagnostic challenges as imaging may suggest separate lesions rather than a single malignancy. Case presentation: A 21-year-old man presented with worsening right upper and central abdominal pain. The contrast-enhanced abdominal CT suggested that the intussusception at the ileocecal region might be caused by a lipoma and revealed a separate mass in the transverse colon. Emergency laparoscopic exploration and subsequent open laparotomy conﬁrmed a 4.0-cm × 5.0-cm cauliﬂower-like adenocarcinoma originating from the ileocecal region, which had caused the intussusception and mimicked separate pathologies on imaging. Conclusions: This case highlights the diagnostic complexity of synchronous intestinal lesions in young patients. It underscores the need for a heightened suspicion of an underlying malignancy when encountering intussusception and emphasizes the limitations of imaging in accurately characterizing the complex pathology of the bowel. KEYWORDS colorectal cancer (CRC), diagnostic challenges, intussusception, Occam ’s razor principle, young adults Background/introduction Colorectal cancer (CRC) in young adults under 25 years of age accounts for less than 1% of all cases, with only 0.08 cases per 100,000 population reported in surveillance studies (1) . While intussusception is a recognized but rare initial manifestation (occurring in 0.3%– 0.5% of colorectal malignancies) (2), the coexistence of intussusception and synchronous colonic mass poses unique diagnostic challenges. Such presentations are frequently Frontiers in Oncology 01 [frontiersin.org](frontiersin.org) misattributed to benign etiologies such as lipomas or inﬂammatory lesions, particularly when the lesions appear anatomically indistinct on imaging (3) . This case highlights a critical diagnostic pitfall where ileocecalintussusception and a transverse colon mass were initially interpreted as separate pathological entities. Preoperative CT ﬁndings suggested two discrete lesions: 1) ileocecalintussusce

FAQs

Why is intussusception in adults diagnostically challenging in young patients?

Adult intussusception is rare and is often associated with tumors. In young patients, it may coexist with colorectal cancer, and imaging can suggest separate lesions rather than a single malignancy.

What did imaging initially suggest, and what was found at surgery?

Contrast-enhanced abdominal CT suggested intussusception in the ileocecal region possibly caused by a lipoma, along with a separate mass in the transverse colon. Emergency exploration and subsequent laparotomy confirmed one cauliﬂower-like adenocarcinoma originating from the ileocecal region that had induced the intussusception.

What clinical lessons does the case emphasize?

The report highlights diagnostic pitfalls with anatomically discordant lesions, the need for heightened suspicion of malignant continuity despite young age, and the limitations of CT in accurately characterizing complex bowel pathology when mesenteric involvement is present.

Sep 28, 2026

Uploaded by Finn