Introduction Schistosomiasis is a trematodes infection more prevalent in tropical and subtropical areas such as Yemen. Giant colonic polyp manifestations of intestinal bilharziasis are uncommon, difficult to differentiate from other colonic polyps, and can mimic cancer. Case Report A 10-year-old child presented with chronic abdominal pain that started ten months ago. The patient had a family history of lymphoma in his brother. The computed tomography scan showed a sigmoid luminal mass measuring 10×3 cm with significant lumen narrowing and diffuse circumferential wall thickening of the sigmoid colon, hepatomegaly, and multiple perilesional, para-hepatic, and pulmonary lymph nodes enlargements. The mass was morphologically mimicked cancer and proved to be of bilharzial etiology ( Schistosoma mansoni ) after surgical excision. Conclusion Even though the bilharzial colonic polyps are rare, it is challenging to differentiate them from other malignant colonic polyps. Clinicians should have a high suspicion regarding its manifestations to avoid unnecessary surgical interventions, especially in an endemic area, even in patients with a strong family history of cancer.
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