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Adenocarcinoma arising in a duplication of the cecum.

Jung KH, Jang SM, Joo YW, Oh YH, Park YW, Paik HG, Choi JH - Korean J. Intern. Med. (2012)

Bottom Line: Intestinal duplications are rare developmental abnormalities that may occur anywhere in the gastrointestinal tract.The possibility of a malignant change occurring in these duplications is very low.Excision of the mesenteric mass and a right hemicolectomy was performed.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.

ABSTRACT
Intestinal duplications are rare developmental abnormalities that may occur anywhere in the gastrointestinal tract. The possibility of a malignant change occurring in these duplications is very low. We present a case of adenocarcinoma arising in a duplication of the cecum. A 41-year-old male patient was admitted because of a palpable abdominal mass. Abdominal computed tomography revealed a 6-cm, peripheral wall-enhanced, round, cystic mass in the cecal area. Excision of the mesenteric mass and a right hemicolectomy was performed. Upon histologic examination, the patient was diagnosed with adenocarcinoma arising in a duplication of the cecum.

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Intraoperative findings: the cystic mass is loosely attached to the cecal serosal surface.
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Figure 2: Intraoperative findings: the cystic mass is loosely attached to the cecal serosal surface.

Mentions: A 41-year-old man presented with a palpable abdominal mass and loose stool, which had developed two months previously. There was no history of disease except for pulmonary tuberculosis, which had completely resolved. Physical examination revealed an approximately 4 × 4 cm, round, non-tender, mobile mass in the right lower quadrant of the abdomen. There was no cervical, axillary, or inguinal lymphadenopathy and no hepatosplenomegaly. The complete blood count, liver function, and kidney function test results were normal. The serum tumor marker, carcinoembryonic antigen (CEA), was within a normal range (1.55 ng/mL; normal range, < 5.0 ng/mL), but cancer antigen 19-9 (CA 19-9) was elevated (82.03 U/mL; normal range, < 37 U/mL). Abdominal computed tomography (CT) revealed a 5 × 4.8 × 6 cm, peripheral wall enhanced, round cystic mass in the cecal area (Fig. 1A). Peripheral calcification and an enhanced solid component were observed in the lower portion (Fig. 1B). No regional lymph node, ascites, or other abnormalities were found. Results of a colonoscopy performed at another hospital several months earlier were normal. During surgery, the cystic mass was observed to be loosely attached to the cecal serosal surface (Fig. 2). It was dissected free and removed intact, then submitted to the department of pathology for frozen section diagnosis; results indicated adenocarcinoma, possibly arising in a cecal duplication cyst. A right hemicolectomy was subsequently performed. Upon gross examination, the spherical cystic mass was tender and firm, and the outer surface was smooth and glistening with a small amount of omental soft tissue attached. Upon opening, the cystic mass revealed a unilocular space containing abundant brown mucinous fluid. The inner surface was smooth and showed multiple brownish spots. The wall was approximately 0.5 cm thick. On serial sectioning, the cut surface revealed a localized grayish white and friable lesion that had infiltrated the adjacent tissue (Fig. 3).


Adenocarcinoma arising in a duplication of the cecum.

Jung KH, Jang SM, Joo YW, Oh YH, Park YW, Paik HG, Choi JH - Korean J. Intern. Med. (2012)

Intraoperative findings: the cystic mass is loosely attached to the cecal serosal surface.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3295976&req=5

Figure 2: Intraoperative findings: the cystic mass is loosely attached to the cecal serosal surface.
Mentions: A 41-year-old man presented with a palpable abdominal mass and loose stool, which had developed two months previously. There was no history of disease except for pulmonary tuberculosis, which had completely resolved. Physical examination revealed an approximately 4 × 4 cm, round, non-tender, mobile mass in the right lower quadrant of the abdomen. There was no cervical, axillary, or inguinal lymphadenopathy and no hepatosplenomegaly. The complete blood count, liver function, and kidney function test results were normal. The serum tumor marker, carcinoembryonic antigen (CEA), was within a normal range (1.55 ng/mL; normal range, < 5.0 ng/mL), but cancer antigen 19-9 (CA 19-9) was elevated (82.03 U/mL; normal range, < 37 U/mL). Abdominal computed tomography (CT) revealed a 5 × 4.8 × 6 cm, peripheral wall enhanced, round cystic mass in the cecal area (Fig. 1A). Peripheral calcification and an enhanced solid component were observed in the lower portion (Fig. 1B). No regional lymph node, ascites, or other abnormalities were found. Results of a colonoscopy performed at another hospital several months earlier were normal. During surgery, the cystic mass was observed to be loosely attached to the cecal serosal surface (Fig. 2). It was dissected free and removed intact, then submitted to the department of pathology for frozen section diagnosis; results indicated adenocarcinoma, possibly arising in a cecal duplication cyst. A right hemicolectomy was subsequently performed. Upon gross examination, the spherical cystic mass was tender and firm, and the outer surface was smooth and glistening with a small amount of omental soft tissue attached. Upon opening, the cystic mass revealed a unilocular space containing abundant brown mucinous fluid. The inner surface was smooth and showed multiple brownish spots. The wall was approximately 0.5 cm thick. On serial sectioning, the cut surface revealed a localized grayish white and friable lesion that had infiltrated the adjacent tissue (Fig. 3).

Bottom Line: Intestinal duplications are rare developmental abnormalities that may occur anywhere in the gastrointestinal tract.The possibility of a malignant change occurring in these duplications is very low.Excision of the mesenteric mass and a right hemicolectomy was performed.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.

ABSTRACT
Intestinal duplications are rare developmental abnormalities that may occur anywhere in the gastrointestinal tract. The possibility of a malignant change occurring in these duplications is very low. We present a case of adenocarcinoma arising in a duplication of the cecum. A 41-year-old male patient was admitted because of a palpable abdominal mass. Abdominal computed tomography revealed a 6-cm, peripheral wall-enhanced, round, cystic mass in the cecal area. Excision of the mesenteric mass and a right hemicolectomy was performed. Upon histologic examination, the patient was diagnosed with adenocarcinoma arising in a duplication of the cecum.

Show MeSH
Related in: MedlinePlus