A child was operated for intussusceptions. He underwent resection of the affected ileal segment which revealed a tumor. The most likely tumor would be:
Ans is 'b' i.e. Villous adenoma The vast majority of cases of intussusception does not have a pathologic lead point and are classified as primary or idiopathic intussusceptions. Approximately 5 to 25 % of children have pathological lead points (percentages vary from book to book). "The most common pathologic lead point is a Meckel's diveiculum followed by polyps and duplications. Other benign lead points are the appendix, hemangiomas, carcinoid tumors, foreign bodies, ectopic pancreas or gastric mucosa, hamaomas from Peutz-Jeghers syndrome, and lipomas. Malignant causes, which are very rare, include lymphomas, lymphosarcomas, small bowel tumors, and melanomas." - Ashcraft's Pediatric Surgery , Fifth edition George Whitfield Holcomb, J. Patrick Murphy, and Daniel J. Ostlie Chapter 39 Frankly we have not got any documented evidence that 'vinous adenoma' is the most common pathological lead point among the given options. What we get is that 'polyps' are the 2" most common pathological lead point after Meckel's diveiculum. But the problem is that 'vinous adenomas' constitute a very small percentage of all the polyps. Still this is our best option. We have confirmed this from a Prof. of Surgery.
Lymphoma
Villous adenoma
Carcinoid
Smooth muscle tumor