PMC6159284_01
Images showing hyperpigmented macules on the lips, palms and sole.
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fig1
On examination, there were multiple hyperpigmented macules on the lips, palms and soles (Figure 1).
(a) Axial CT scan showing a heterogeneous peripherally enhancing mass in the mesentery just above the level of the renal hilum; the mass was not separate from the jejunal loops and was abutting the superior mesenteric artery, with maintained fat plane. (b) Reformatted oblique axial CT scan showing telescoping of the descending colon into the sigmoid colon, and the caecum into the ascending colon; however, the invaginated loop showed normal enhancement. (c) Coronal reformatted CT scan showing telescoping of the descending colon into the sigmoid colon, and the caecum into the ascending colon; however, the invaginated loop showed normal enhancement. (d) Axial CT image demonstrating multiple enhancing polyps in the stomach.
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fig2
The CT scan showed a heterogeneous peripheral enhancing mass in the mesentery just above the level of the renal hilum, which was not separate from the jejunal loops (Figure 2). A large, enhancing polypoid mass was noted at the tip of the invaginated bowel loops at the two sites acting as lead points (Figure 2b,c). Multiple intraluminal polyps were also noted in the stomach, jejunum and colon (Figure 2d).
PMC6159284_02
(a) Intraoperative photograph demonstrating the colocolic intussusceptions, which were reduced. (b) Intraoperative photograph demonstrating a nodular mass in the jejunum infiltrating into the root of the superior mesenteric artery.
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fig3
Also synchronous colocolic intussusceptions were confirmed, which were reduced (Figure 3a,b).