28250406 Visualization

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