case_images: PMC6617874_01
case_images: FDG-PET scan with an extensive right upper lobar and mediastinal mass in keeping with primary non-small-cell lung cancer (arrow). Intense heterogenous uptake in the sigmoid colon (white arrow), which could represent a synchronous malignancy or complication secondary to diverticular disease.
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case_images: fig1
case_images: This was suspicious for a metastatic deposit or a complication secondary to diverticular disease (Figure 1).
case_images: Axial CT highlighting a focal area of thickening in the wall of the sigmoid colon with surrounding diverticula.
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case_images: fig2
case_images: A CT scan was performed which demonstrated a focal area of thickening of the sigmoid colon (Figure 2); however, given the recent colonoscopy findings, the possibility of malignancy was deemed less likely in this situation.
case_images: Sagittal CT highlighting a hyperdense tubular foreign object in the sigmoid colon (arrow), in addition to displaying a mass-like thickening of the sigmoid colon.
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case_images: fig3
case_images: A CT scan demonstrated circumferential thickening of the bowel wall in the sigmoid colon and a suspicious-looking intraluminal tubular structure distal to this, suspicious for a foreign body (Figures 3 and 4).
case_images: Axial CT scan. Arrow points out a cross-sectional image of the foreign body in question. Meanwhile, the area outlined represents the mass-like thickening of the sigmoid colon proximal to the foreign body.
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case_images: fig4
case_images: A CT scan demonstrated circumferential thickening of the bowel wall in the sigmoid colon and a suspicious-looking intraluminal tubular structure distal to this, suspicious for a foreign body (Figures 3 and 4).
case_images: FDG-PET scan of our patient, following two weeks of serial radiological imaging, to monitor the foreign body. An intensely FDG-PET avid mass in the sigmoid colon was highlighted on imaging (arrow).
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case_images: fig5
case_images: A repeat FDG-PET-CT scan was conducted, revealing an intensely FDG avid mass in the midsigmoid colon (Figure 5).
case_images: Image of chicken bone retrieved with flexible sigmoidoscopy. The bone measured 6 cm in length with no apparent sharp edges.
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case_images: fig6
case_images: This revealed a chicken bone impacted in the sigmoid colon (Figure 6).
case_images: Coronal CT of the abdomen and pelvis highlighting an intramural sigmoid mass (a). Furthermore, the appearance of abscess transformation was noted, with gas locules evident (b).
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case_images: fig7
case_images: A further CT scan raised concern that this mass had become an intramural abscess with images displaying some gas locules within it (Figure 7).
case_images: Image of resected sigmoid mass, following laparotomy. Histopathology confirmed the mass to be metastatic lung cancer.
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case_images: fig8
case_images: She underwent a resection of this sigmoid mass along with a contiguous segment of the bladder (Figure 8).
case_images: Photomicrograph of patient's resected sigmoid mass. (a) H&E staining displaying atypical tumour cells and areas of necrosis under 100x magnification. (b) Specimen under 100x magnification with CK7 staining outlining a diffuse distribution of tumour cells.
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case_images: fig9
case_images: Histopathology confirmed that this mass was a large deposit of metastatic lung cancer (Figure 9).