A Rare Adult Ileal Intussusception Caused by Perineurioma.
Chuah YY, Ooi SW, Hsieh SP, Tzeng WS, Lee YY, Shiue YL, Tu CM, Liao CY
Adult intussusception is an uncommon condition that usually indicates an underlying pathological lead point. Ileal perineurioma is an exceptionally rare benign peripheral nerve sheath tumor with limited gastrointestinal reports. We describe a 59-year-old woman presenting with acute severe abdominal pain, vomiting, and distension. Contrast-enhanced computed tomography demonstrated ileal intussusception with small-bowel obstruction. Emergency laparotomy confirmed terminal ileal intussusception, and segmental resection was performed. Histopathological evaluation revealed a spindle-cell neoplasm with characteristic pseudo-onion bulb architecture. Immunohistochemistry showed strong positivity for epithelial membrane antigen (EMA) and Glucose Transporter-1 (GLUT-1), while other markers were negative, confirming perineurioma. The postoperative course was uneventful, with no recurrence on follow-up. This case highlights ileal perineurioma as a rare but important differential diagnosis in adult small-bowel intussusception, with definitive diagnosis reliant on histopathological and immunohistochemical evaluation.