Mass-Forming Ischemic Colitis: A Potential Mimicker of Malignancy

Abstract

Ischemic colitis (IC) results from reduced colonic vascular perfusion, accounting for 50-60% of all gastrointestinal ischemic episodes. IC leads to mucosal damage with clinical symptom severity developing based on the duration and extent of colonic injury. In rare cases IC may form a mass-like lesion mimicking malignancy. Here we present the case of a 55-year-old female with hematochezia and diarrhea, who on workup was found to have a mass-like lesion at the ileocecal valve. Multiple biopsies demonstrated ischemic change and mucosal injury without evidence of dysplasia or carcinoma. Two months later on follow-up imaging, after supportive treatment the lesion was completely resolved. It is critical for gastroenterologists and pathologists to be aware of this variant of IC to avoid unnecessary surgical procedures and treatment of patients.

Diagnostic methods and drug therapies in patients with ischemic colitis

“…"Single stripe" refers to a single line of erythema with inflammatory erosion or ulceration along the longitudinal axis of the colon, and is highly specific [1,29]. In a few rare cases, IC lesions can form tumor-like lesions that are similar to malignant tumors [51,52].…”

Ischemic Colitis Presented as Pseudomembranous Colitis: An Untypical Case from Vietnam

“…Although the IC is initially suspected of being colon carcinoma only in a few cases, it was challenging to rule out a malignant diagnosis in our elderly patient. 4,11,13 Despite the endoscopic and CT features indicating a carcinoma, the biopsy results in all cases were negative for a malignancy. 4,6,11,13 Moreover, in some cases, the follow-up colonoscopies performed several weeks later showed the resolution of those masses.…”

“…4,11,13 Despite the endoscopic and CT features indicating a carcinoma, the biopsy results in all cases were negative for a malignancy. 4,6,11,13 Moreover, in some cases, the follow-up colonoscopies performed several weeks later showed the resolution of those masses. 4 In the present case, he had undergone a screening colonoscopy after ostomy reversal surgery without colorectal neoplasm synchronously.…”