[Plasma-cell granuloma of the sigmoid colon concomitant with adenocarcinoma of the cecum. Viewpoint for debate, literature review on pseudotumors, idiopathic colitis and cancer].
A case of colonic pseudotumor, causing intestinal occlusion, concomitant with a caecum neoplasia is reported. A male 69 years old was referred to our Institution for colic abdominal pain: colonoscopy aborted because of an insuperable sigma stenosis; diagnostic enema confirmed the sigmoid stenosis, originally advised as neoplastic. As operation, the sigmoid tumor appeared accompanied with enlarged draining lymph nodes and peritoneal sac was disseminated of miliary-like whity granules. Hystological examination showed a plasma-cell granuloma with nodular and peritoneal chronic inflammatory reaction. A pancolonoscopy, performed fourty days later, discovered an unsuspected adenocarcinoma neoplasia of the caecum, that was resected with a second operation. Regional nodes were not involved. The authors make a review of international literature about of plasma-cell granuloma, pseudotumor and inflammatory chronic bowel diseases in order to identify possible correlations between pseudotumor and neoplasms. The extremely low incidence of plasma-cell granulomas in the alimentary tract (17 case since 1970 to 1994) and the reported association with concomitant neoplasms (29%) suggest to consider extremely useful an accurate study of patients with intestinal pseudotumors in order to identify neoplasms of the gastrointestinal tract as well as of other organs.
De Monti
M
M
Università degli Studi di Milano, Cattedra di Chirurgia Generale.
Ghilardi
G
G
Cavenati
S
S
Reale
D
D
Pezzica
E
E
Scorza
R
R
D000230:Adenocarcinoma / Q000150:complications; D000368:Aged; D002430:Cecal Neoplasms / Q000150:complications; D003092:Colitis / Q000209:etiology*; D006104:Granuloma, Plasma Cell / Q000150:complications / Q000473:pathology; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology; D008297:Male; D009378:Neoplasms, Multiple Primary; D012810:Sigmoid Diseases; D012811:Sigmoid Neoplasms / Q000150:complications