A Case of Inflammatory Pseudotumor Generated on Appendix

Junji Akagi, Noriaki Takahashi, Shinji Okazaki, Eiji Takai, Takahiro Takemoto, Yasuhiro Yagishita¹⁾, Ryoichi Kurano²⁾ and Yoichi Tanoue³⁾

Department of Surgery and Department of Anesthesia¹⁾,
National Hospital Organization Kumamoto Minami Hospital
Department of Pathology, Kumamoto Medical Association Medical Center²⁾
Tanoue Clinic³⁾

A 76-year-old man complained of a right lower abdominal pain beginning in January 2005. A colonoscopy showed an elevated lesion in the cecum (30 mm), and a blood analysis suggested inflammation (WBC, 13,320/μl., CRP, 12.6 mg/dL). Although the pathological findings for a biopsy of the elevated lesion suggested a Group I lesion, the possibility of malignancy could not be ruled out. Therefore, an ileocecal resection was performed on February 2005. Phlegmonous appendicitis and an elevated lesion of the cecum extending from the entrance of the appendix to the upper part of the appendix were observed during the operation. Pathological examination of the resected specimen showed a strong, fibrous connective tissue growing on the elevated lesion but no atypical cells or tumorous growth on the epithelial cells. These findings strongly suggested that the elevated lesion was an inflammatory pseudotumor (IPT) caused by the phlegmonous appendicitis. IPT of the colon and rectum is very rare, and, to our knowledge, only 23 reports (including ours) on IPT of the colon or rectum have been made, of which six cases arose from the appendix. In this case, IPT made inflammation of the appendix worse by growing and obstructing the entrance of appendix, which suggest that IPT should be resected as soon as possible.

Key words
inflammatory pseudotumor, appendix, colon

Reprint requests
Junji Akagi Department of Surgery, National Hospital Organization Kumamoto Minami Hospital
2338 Toyofuku, Matsubase-machi, Uki, 869-0593 JAPAN

Accepted
April 26, 2006

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