A 47-year-old man presented with a 1-year history of intermittent abdominal pain and
hematochezia for 1-week. He had a medical history of diabetes mellitus for 6 years.
The physical examination was unremarkable. Laboratory tests showed moderate anemia
and positive stool occult blood. Contrast-enhanced computed tomography showed circumferential
wall thickening with uneven enhancement in the ascending colon, accompanied by bulky
swollen lymph nodes (Fig. 1A). Colonoscopy revealed a large cauliflower-shaped mass occupying the whole lumen
in the ascending colon, with necrosis and erosions on the surface (Fig. 1B). Multiple endoscopic mucosal biopsies showed moderately differentiated adenocarcinoma.
Following 2 cycles of XELOX (capecitabine/oxaliplatin) chemotherapy, the patient underwent
right hemicolectomy and end-to-side anastomosis. Unexpectedly, gross specimen revealed
that the upper part of the cut surface was grayish-white and hard in texture with
ulcers (Fig. 2A, red circle), while the deeper part was a white nodular lesion, with a homogenously
tender texture (Fig. 2A, black circle).
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References
- Collision tumor comprising primary malignant lymphoma and adenocarcinoma in the ascending colon.Case Rep Gastroenterol. 2021; 15: 379-388
- Analysis of clinical and pathological findings in inflammatory fibroid polyps of the gastrointestinal system: A series of 69 cases.Ann Diagn Pathol. 2018; 37: 47-50
- A rare cause of colonic obstruction: inflammatory fibroid polyp.Cureus. 2022; 14: e23868
Article info
Publication history
Published online: February 14, 2023
Accepted:
February 8,
2023
Received:
October 25,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.