Abstract
A 60-year-old man admitted to the hospital because of dysuria was found having right hydronephrosis and a tumor of the ileocecal region on abdominal CT scan and abdominal ultrasonography. He felt no abdominal tenderness. There were no abnormalities in laboratory data. Colonoscopy showed a submucosal tumor with a smooth surface at the appendiceal orifice, and abdominal CT scan showed a tumor with an unclear margin in the ileocecal region and right hydronephrosis due to obstruction of the right ureter by the tumor. Appendiceal tumor complicated with right hydronephrosis was suspected, and a right hemicolectomy with D3 lymph node dissection and a partial resection of the sigmoid colon were carried out. Histological findings reveled the tumor tissue as fibrous granuloma, and the submucosal tumor at the appendiceal orifice as a non-neoplastic lesion due to interstitial fibrosis.
In making diagnosis of an ileocecal tumor, hydronephrosis and an ileocecal polypoid lesion should be kept in mind as symptoms of appendicitis. In such a case, we should decide the operative procedure according to intraoperative frozen section diagnosis to avoid over surgery.
