Solitary Fibrous Tumor of the Shoulder Metastasizing to the Small Intestine Presenting as Intussusception: A Case Report

Solitary fibrous tumors (SFTs) are rare vascular malignancies that are rarely reported in the upper limb, and even rarer as secondary metastasis to the small bowel. We present a case of a 39-year-old male patient, a known case of metastatic SFT, presenting with severe abdominal pain and vomiting. Computed tomography showed ileo-ileal intussusception. Subsequently, he underwent surgical resection. Histopathological examination showed high-grade sarcoma of the intestinal wall, confirming small intestinal metastasis. This constitutes one of the rare cases of SFTs metastasizing to the small bowel, specifically to the ileum. A review of the literature on similar cases is presented. There appears to be a connection between upper limb SFT and bowel metastasis according to reported literature. However, the scarcity of similar reports makes the generalizability of the conclusion limited.

A Pediatric Case of Inverted Meckel's Diverticulum Presenting with Cyclic Vomiting-like Symptoms: A Case Report and Literature Review

Asymptomatic Meckel's diverticulum cases are not uncommon, leading to diagnostic difficulties in cases of atypical presentations with only gastrointestinal symptoms other than bloody stool. A nine-year-old boy diagnosed as having cyclic vomiting because of recurrent abdominal pain and vomiting for 6 months was referred to our institute and hospitalized due to worsening symptoms. After admission, abdominal ultrasonography showed the multiple concentric ring sign and a pseudokidney sign at the lower ileum, leading to the diagnosis of ileo-ileal intussusception, but the gastrointestinal symptoms and ultrasonic findings disappeared spontaneously. Transanal, double-balloon, intestinal endoscopy demonstrated a pedunculated polyp-like structure, and surgical resection was performed. An inverted diverticulum was found in the resected intestinal lumen, and ectopic gastric mucosa was identified histologically, leading to the diagnosis of inverted Meckel's diverticulum. In pediatric cases involving periodic attacks of vomiting and abdominal pain, unnecessary emergent surgery could be avoided by cautious imaging evaluation and consideration of ileo-ileal intussusception with advanced lesions of an inverted Meckel's diverticulum as a differential diagnosis, without facilely diagnosing cyclic vomiting. In addition, previous reports of inverted Meckel's diverticulum were reviewed, and the results were compared between adult and pediatric groups in each category.

Adult Mid Ileo-Ileal Intussusception Secondary to Inflammatory Myofibroblastic Tumor (IMT): A Case Report and Literature Review

The intestinal intussusception as a cause of bowel obstruction in adult is a rare finding and is a heralder for an underlying lesion. This is in stark contrast to intestinal intussusception in pediatric population where the etiology is always a primary or benign condition and thus bears different outcomes. We hereby present a case of a young female adult, without the presence of any significant comorbidity. She presented with non-specific symptoms of small bowel intussusception. She was diagnosed as a case of adult intussusception with abdominal ultrasonography. The patient underwent complete resection of the tumor, without any reduction attempts, as the best plausible therapeutic approach. Further, in post-operative evaluation, complete pathological analysis of the resected specimen divulged the presence of inflammatory myofibroblastic tumor (IMT) as the underlying lead point of mid-ileo-ileal intussusception.