A 60-year-old woman diagnosed with hiatal hernia and lactose intolerance.
The patient consults because she has had diarrhea for a month, sometimes with rectal bleeding and abdominal pain.
A normal biochemical and hematological study was performed, including thyroid hormones and liver profile.
Tumor markers CEA, CA.
125 and CA 19.9 were also normal.
Abdominal ultrasound shows that in the left iliac fossa there is a rounded image, slightly hyperechogenic, about 45 mm, which could correspond to an intrasinusal lesion or an artifact.
Fibrocolonoscopy was performed to observe a large polypoid mass located in the middle third of the sigmoid colon. The mass was superficially naked and deep blue. It had a hard consistency of about 7 cm, displaceable.
Given the nonspecific nature of the lesion and the absence of obstruction of the colonic lumen, colonic stenting was not performed and it was decided to refer the patient to surgery to assess surgical intervention of the lesion.
Before surgery, an abdominal CAT scan showed a tumor in the junction of the descending colon with the sigmoid colon with thickening of the wall and reduction of the intestinal lumen.
The patient finally underwent a left hemicolectomy.
Upon opening, an excrecent polypoid neoformation is identified; externally, it is a surface with a maximum diameter of 2 cm and occupies the intestinal lumen almost completely.
At the cuts, this neoformation is whitish, asymmetrical, homogeneous and seems to be surrounded by a wall that delimits it most of the time.
Submucosal infarction with epithelial ulceration and fat necrosis was reported.
