Intussusception remains a very rare presentation in adults where the cause is usually a pathological lead point. A common consensus that appears in the literature dictates that most cases of large bowel and ileo-caecal intussusception are secondary to a malignant lesion compared to small bowel intussusception. Pre-operatively determining the nature of the lead point is not always possible but intussusception itself can be readily diagnosed with the use of CT scanning. Surgical resection with or without initial attempts at reduction of the intussusception remains the treatment of choice. A leiomyosarcoma reported only a handful of times in the past, is a rare cause of the same. We present a case of a patient with known metastatic leiomyosarcoma who was incidentally found to have ileo-caecal intussusception during a surveillance CT scan which was subsequently treated with surgical resection and was found to have a metastatic LMS as the lead point.
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