PMC6198103_01
Colonoscopic view of an ulcer that oozed upon slight contact in the terminal ileum.
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A colonoscopy exam revealed an oozing ulcer in the terminal ileum (Fig. 1).
Fluoroscopic study of 5-cm narrowing at the small intestine.
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Fluoroscopic study of the small intestine demonstrated 5-cm narrowing at the terminal ileum (Fig. 2).
Enhanced abdominal computed tomography scan.. A. 45 mm x 55 mm irregular ileocecal wall thickness with enhancement.. B. Low density mass such as an abscess caudal of the tumor.
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Enhanced computed tomography showed 45 mm x 55 mm irregular ileocecal wall thickness with enhancement (Fig. 3).
Surgical findings.. A. A tumor surrounded by fatty tissue and omentum was located in the ileocecal area, and an adhesion was formed between the right internal inguinal ring.. B. Right spermatic cord was dissected because it was involved in the tumor (arrow: right spermatic cord).
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A tumor surrounded by fatty tissue and omentum was located in ileocecal area and adhered to the right internal inguinal ring (Fig. 4A). We dissected the right spermatic cord because it was involved in the tumor (Fig. 4B).
Resected specimen revealed a fistula between the appendiceal orifice and ileac ulcer. (yellow arrow, appendiceal orifice; red arrow: ileac ulcer).
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The resected specimen revealed a fistula between the appendiceal orifice and ileac ulcer (Fig. 5).
Histopathological examination revealed well differentiated tubular adenocarcinoma (hematoxylin and eosin).. Tumoral tissue was revealed in the mucosal membrane of the appendix but not in the iliac ulcer. Iliac ulcer was derived from the appendiceal site.
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Histopathological examination showed a well differentiated tubular adenocarcinoma; tumoral tissue was revealed in the mucosal membrane of the appendix but not in the iliac ulcer (Fig. 6).