--- a
+++ b/processing/MACCROBAT/28250406.txt
@@ -0,0 +1,28 @@
+A 68-year-old man referred to the Internal Medicine Department of Razi Hospital in Rasht (a city in the north of Iran) with a hypogastric region discomfort, especially in the right lower quadrant for one month.
+The pain was a colicky form which had a few episodes each day, each episode lasting for 4–5 minutes.
+The pain radiated to the back and was alleviated by resting to one side.
+No association between the pain, defecation, and eating were reported.
+Furthermore, the patient complained of a 2–3 kg weight loss over the last one month followed by anorexia.
+However, no symptoms of nausea, vomiting, fever, or shaking chills were demonstrated.
+He was first admitted to another center for a week, then was referred to our hospital for further evaluation.
+The patient had undergone a surgery for prostatectomy seven years before his presentation to our center.
+Also, he had a history of endoscopy five years earlier due to dyspepsia, which was found to be Helicobacter pylori positive at that time and which was eradicated after a treatment course.
+No history of HIV, diabetes, smoking, or alcohol consumption was recorded.
+His vital signs were normal at the time of admission.
+On physical examination, the abdomen was soft, there was no distention, and bowel sounds were normoactive.
+However, tenderness in the right lower quadrant of the abdomen with no rebound state was noted.
+The peripheral blood analysis is shown in Table 1.
+Stool examination, urine analysis, and evaluation of electrolytes were all normal.
+An abdominal CT scan showed a well-demarcated and homogenous solitary mass in the cecum with no distention in the ileum.
+The ileum wall was thickened (Figure 1).
+A colonoscopy revealed a large mass like lesion in the cecum (Figure 2); during the procedure a biopsy was taken from the cecum.
+The lamina propria was infiltrated by a number of PMNCs admixed by some eosinophils (Figure 3).
+Immunohistochemical evaluation was positive for vimentin and CD68.
+C-Kit (CD117) was negative while CD34, smooth muscle actin (SMA), and ALK were focally positive.
+There were no reports of cyclin D1, desmin, or pancytokeratin (Figure 4).When the colonoscopy was performed, the evidences of invasive obstruction lead us to the suspicion of a malignant tumor.
+After pathological confirmation of IMT, the patient was referred for surgery in order to remove the mass.
+On surgery, approximately 40 mL ascites were found in the abdomen.
+A mass was seen in the cecum with ileocolic intussusception.
+Afterwards, the patient underwent right hemicolectomy with an end-to-end anastomosis of ileocolic.
+No enlarge lymph nodes were observed.
+The patient was discharged seven days after surgery and had no complications during follow-up.