BENIGN MASQUERADE – A RARE CASE OF COLONIC MALIGNANCY LURKING BEHIND AMEBIC COLITIS

Keywords: invasive amoebiasis, amoeboma, colitis, malignant masquerade

Abstract

A 45 year old female patient presented with intestinal obstruction due to rectal stricture and associated radiologic findings and histopathology indicative of invasive amebiasis. Suspicion of neoplasia arose due to incomplete response to antiamebic therapy which could only be proved after repeated biopsies. Amebic colitis has been reported to masquerade as colorectal malignancy. In contrast, we herein present a case of rectal malignancy presenting primarily as amebic colitis, creating considerable difficulty in diagnosis and management. This ‘benign masquerade’ in which a malignant disease mimics or is masked by a benign pathology is particularly problematic since it lets the malignant pathology progress. A failure of complete resolution of amebic lesions with antiamebic therapy should be considered a red flag and possibility of a more sinister coexisting pathology must be excluded in such cases. The patient had generalized invasive colonic amebiasis which is extremely rare.  The unique radiologic appearance of generalized invasive colonic amebiasis is illustrated.

Author Biographies

Dharamanjai Kumar Sharma, Rabindra Nath Tagore Medical College, Udaipur, Rajasthan, India

Senior Professor & Unit Head, Department of Surgery, RNT Medical College, Uadaipur, Rajasthan

M.S. (Surgery), M.Ch. (Gastro-Intestinal Surgery)

Hina Sharma, Geetanjali Medical College & Hospitral, Udaipur, Rajasthan, India

Associate Professor

Department of Anatomy

Geetanjali Medical College & Hospital, Udaipur, Rajasthan

References

[1] J. M. Cardoso, K. Kimura, M. Stoopen, et. al., “Radiology of invasive amebiasis of the colon”, AJR Am. J. Roentgenol, vol. 128(6), pp 935-41, 1977.
[2] M. Agrez, C. Karihaloo, G. Reeves, M. Puvaneswary, L. Sturm and J. Scurry, “Rectal cancer masquerading as an amoeboma: case report and review of the literature”, A. N. Z. J. Surg. Vol. 74(9), pp. 812-815, 2004.
[3] R. E. Hardin, G. S. Ferzli, M. E. Zenilman, P. K. Gadangi and W. B. Bowne, “Invasive amebiasis and ameboma formation presenting as a rectal mass: An uncommon case of malignant masquerade at a western medical center”, World. J. Gastroenterol., vol. 13(42), p 5659, 2007.
[4] R. N. Messersmith and G.J. Chase, “Amebiasis presenting as multiple apple core lesions”, Am. J. Gastroenterol., vol. 79(3), pp. 238-41, 1984.
[5] T. Tsujimoto, S. Kuriyama, H. Yoshiji, et. Al., “Ultrasonographic findings of amebic colitis”, J. Gastroenterol., vol. 38(1), pp. 82-86, 2003
[6] C. G. Spicknall and E. C. Peirce, “Amebic granuloma: Report of four cases and review of the literature”, N. Engl. J. Med., vol. 250(25), pp. 1055-1062. 1954
[7] J. M. Rominger and A. N. Shah, “Ameboma of the rectum”, Gastrointest. Endosc., vol. 25(2), pp. 71-73, 1979.
[8] R. A. Radke, “Ameboma of the intestine: an analysis of the disease as presented in 78 collected and 41 previously unreported cases”, Ann. Intern. Med., vol. 43(5, pp 1048-1066, 1955.
[9] M. Kaya, F. Aydin and H. Buyukbayram, “A rare cause of colonic stricture: amebiasis”, Turk. J. Gastroenterol., vol. 16(4), p. 236, 2005.
[10] N. Zeybek, G. Yagci, O. Mentes and Y. Peker, “Benign anal stenosis after anorectal ameboma”, Firat. Tip. Dergisi.,vol. 12, pp. 62-64, 2007.
Published
2021-12-25
How to Cite
[1]
D. Sharma and H. Sharma, “BENIGN MASQUERADE – A RARE CASE OF COLONIC MALIGNANCY LURKING BEHIND AMEBIC COLITIS”, JSS, vol. 8, no. 4, Dec. 2021.