An unusual cecal submucosal mass in an elderly gentleman.

ABSTRACT

A 60-years-old man with previous hypertension was hospitalized because of colonoscopy revealed a cecal submucosal mass for community health examination 1 month ago. The patient has no symptoms such as poor appetite, fatigue, abdominal pain, diarrhea, nausea and vomiting. Laboratory tests and physical examination was unremarkable. A protrusion with multiple superficial small ulcers on the smooth surface measuring 1.5 × 2.0-cm was found beside the appendiceal orifice by colonoscopy. Abdominal computed tomography demonstrated a high-density mass without enhancement protruding towards the ileocecal cavity at the appendiceal orifice measured 1.5 × 1.8 cm. Laparoscopic ileocecal resection was performed because of appendiceal tumor couldn't be excluded and the patient's strong request. Pathology examination of the postoperative specimen revealed dilated appendix cavity with fecalith inside in the submucosal layer of the ileocecal region. The patient was diagnosed as appendiceal orifice submucosal fecalith. He was discharged home uneventfully and no symptoms was observed in 3 months follow-up.