PDF(Pubmed)
Abstract：
BACKGROUND: Collision tumors involving the small intestine, specifically the combination of a hamartomatous tumor and a lipoma, are extremely rare. To our knowledge, no previous case report has described a collision tumor composed of two benign tumors of different origins in the small intestine.
METHODS: Here, we present the case of an 82-year-old woman who presented with hemorrhagic shock and was found to have a mass measuring approximately 50 mm × 32 mm × 30 mm in the terminal ileum. Based on computed tomography scan findings, the mass was initially suspected to be a lipoma. A subsequent colonoscopy revealed a pedunculated submucosal elevation consisting of two distinct parts with a visible demarcation line. A biopsy of the upper portion suggested a juvenile polyp (JP). Owing to the patient\'s advanced age, multiple comorbidities, and poor surgical tolerance, a modified endoscopic submucosal dissection was performed. Histopathological examination of the excised mucosal mass revealed a lipoma at the base and a JP at the top, demonstrating evidence of rupture and associated bleeding. The patient\'s overall health remained satisfactory, with no recurrence of hematochezia during the six-month follow-up period.
CONCLUSIONS: This case report provides new evidence for the understanding of gastrointestinal collision tumors, emphasizing their diverse clinical presentations and histopathological characteristics. It also offers diagnostic and therapeutic insights as well as an approach for managing benign collision tumors.
METHODS: Here, we present the case of an 82-year-old woman who presented with hemorrhagic shock and was found to have a mass measuring approximately 50 mm × 32 mm × 30 mm in the terminal ileum. Based on computed tomography scan findings, the mass was initially suspected to be a lipoma. A subsequent colonoscopy revealed a pedunculated submucosal elevation consisting of two distinct parts with a visible demarcation line. A biopsy of the upper portion suggested a juvenile polyp (JP). Owing to the patient\'s advanced age, multiple comorbidities, and poor surgical tolerance, a modified endoscopic submucosal dissection was performed. Histopathological examination of the excised mucosal mass revealed a lipoma at the base and a JP at the top, demonstrating evidence of rupture and associated bleeding. The patient\'s overall health remained satisfactory, with no recurrence of hematochezia during the six-month follow-up period.
CONCLUSIONS: This case report provides new evidence for the understanding of gastrointestinal collision tumors, emphasizing their diverse clinical presentations and histopathological characteristics. It also offers diagnostic and therapeutic insights as well as an approach for managing benign collision tumors.
摘要：
背景：累及小肠的碰撞肿瘤，特别是错构瘤和脂肪瘤的组合，极为罕见。据我们所知,以前没有病例报告描述了由两个不同来源的小肠良性肿瘤组成的碰撞肿瘤。
方法：这里，我们介绍了一例82岁女性，她出现了失血性休克，被发现在回肠末端有大约50mm×32mm×30mm的肿块。根据计算机断层扫描的结果,最初怀疑肿块是脂肪瘤。随后的结肠镜检查显示，有两个明显的部分，有明显的分界线。上部的活检提示青少年息肉（JP）。由于病人的高龄，多种合并症,手术耐受性差，进行了改良的内镜黏膜下剥离术.切除的粘膜肿块的组织病理学检查显示底部有脂肪瘤，顶部有JP，证明破裂和相关出血的证据。病人的整体健康状况仍然令人满意，6个月随访期间无便血复发。
结论：本病例报告为了解胃肠道碰撞肿瘤提供了新的证据，强调其不同的临床表现和组织病理学特征。它还提供诊断和治疗见解以及管理良性碰撞肿瘤的方法。
方法：这里，我们介绍了一例82岁女性，她出现了失血性休克，被发现在回肠末端有大约50mm×32mm×30mm的肿块。根据计算机断层扫描的结果,最初怀疑肿块是脂肪瘤。随后的结肠镜检查显示，有两个明显的部分，有明显的分界线。上部的活检提示青少年息肉（JP）。由于病人的高龄，多种合并症,手术耐受性差，进行了改良的内镜黏膜下剥离术.切除的粘膜肿块的组织病理学检查显示底部有脂肪瘤，顶部有JP，证明破裂和相关出血的证据。病人的整体健康状况仍然令人满意，6个月随访期间无便血复发。
结论：本病例报告为了解胃肠道碰撞肿瘤提供了新的证据，强调其不同的临床表现和组织病理学特征。它还提供诊断和治疗见解以及管理良性碰撞肿瘤的方法。
