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Case Reports
. 2025;11(1):24-0090.
doi: 10.70352/scrj.cr.24-0090. Epub 2025 Jun 17.

A Case of Ascending Colon Perivascular Epithelioid Cell Tumor Presenting with Intestinal Intussusception: Case Report

Mitsuki Yokota  1 , Hidekazu Takahashi  1 , Hiromi Tsuji  2 , Yuka Iwami  1 , Juavi Jitjan Watsapol  1 , Shohei Takaichi  1 , Masakatsu Paku  1 , Kazuya Iwamoto  1 , Tomofumi Ohashi  1 , Yujiro Nakahara  1 , Tadafumi Asaoka  1 , Chu Matsuda  1 , Kazuhiro Nishikawa  1 , Ichiro Takemasa  1 , Takeshi Omori  1
Affiliations
Case Reports

A Case of Ascending Colon Perivascular Epithelioid Cell Tumor Presenting with Intestinal Intussusception: Case Report

Mitsuki Yokota et al. Surg Case Rep. 2025.

Abstract

Introduction: Perivascular epithelioid cell tumors (PEComas) arising from the colon are uncommon. This case report describes a 40-year-old woman who presented with lower abdominal pain and was subsequently diagnosed with a colonic PEComa causing intestinal intussusception.

Case presentation: The patient initially presented with lower right abdominal pain. Computed tomography revealed an intestinal mass in the ileocecal region, prompting surgical intervention. Due to the nature of the mass, endoscopic repair was not feasible, and she underwent an emergency laparoscopic ileocecal resection. A significant mass was identified in the ascending colon, comprising proliferating spindle-shaped cells within the colonic wall. Immunohistological analysis revealed positive staining for smooth muscle actin (+), HMB-45 (+), and MelanA (±), confirming the diagnosis of PEComa. The patient recovered uneventfully and was discharged on postoperative day 7.

Conclusions: Colonic PEComa is a rare malignancy. This case adds to the existing knowledge regarding intestinal intussusception caused by colonic PEComa.

Keywords: colon; intussusception; perivascular epithelioid cell tumor (PEComa).

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1. Contrast-enhanced CT scan of the abdomen (A) Superimposition of the ascending colon and the end of the ileum within the transverse colon. (B) 34 mm-sized mass in the advanced part of the colon. (C) Large intestinal peritoneal lymph nodes are observed.
Fig. 2
Fig. 2. Colonoscopy and enema (A) erythematous submucosal tumour in the transverse colon. (B) Very short ascending colon with crab claw sign.
Fig. 3
Fig. 3. Surgical findings (A) Ileocecal stroma. (B) Ileocecal transfer. (C) ICA/ICV dissection. (D) Hepatic kyphosis transfer.
ICA, ileocolic artery; ICV, ileocolic vein
Fig. 4
Fig. 4. Histopathological and immunohistological examination (A) White, substantial mass with a maximum diameter of 61 mm was found in the ascending colon, with negative resection margins. (B) (Hematoxilyn Eosin stain, 40×) The mass was located in the submucosa and partly extended into the mucosal lining, intrinsic layer, intrinsic muscle layer and serosa. (C) (Hematoxilyn Eosin stain, 200×) Within the mass there were bundles of hyperplasia and convoluted spindled cells. (D) (SMA immunostaining 200×) Tumor is diffusely positive. (E) (HMB-45 immunostaining 200×) Tumor is diffusely positive. (F) (MelanA immunostaining 200×) Tumor is diffusely positive.
SMA, smooth muscle actin
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