Presentation
Patient with abdominal pain and palpable mass 2 months ago.
Patient Data
In the right iliac fossa, circumferential mural thickening of the cecum is observed, heterogeneous to the contrast medium. Anterior to the cecum , there is a heterogeneous collection, with thick walls and enhancement with contrast medium, associated with striation of the perilesional fat.
Enlarged ileocolic and retroperitoneal lymph nodes.
Case Discussion
Surgical intervention was performed with the probable diagnosis of appendiceal phlegmon, findings of a cecal tumor with abscess.
The histopathology and immunohistochemistry result showed moderately differentiated invasive adenocarcinoma with loss of nuclear expression of the DNA repair enzymes MLH1 and PMS2 (dysfunctional MMR microsatellite system), preserved nuclear expression of the DNA repair system genes MSH6 and MSH2, and HER2 negative.
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