A 45-year-old male presented to his physician with the complaint of abdominal pain for 6 months. In addition to this pain, the patient related a loss of appetite with difficulty eating and frequent emesis over this period of time. In total, he had lost 20 pounds in the last 2 months, which was attributed to eating less. On physical examination, the patient’s abdomen was distended, with decreased bowel sounds. An abdominal X-ray (not shown) showed dilated loops of small intestine; however, no free air was present. An abdominal CT scan (Figure 1) was performed and revealed thickening of the terminal ileal wall and a mass in the ileocecal mesentery.
The patient was taken to surgery and right hemicolectomy was performed. On gross examination (Figure 2), there was a 7.5 cm tumor that circumferentially involved the intestinal wall and extended into the surrounding mesentery. The small intestinal mucosa overlying the mass was ulcerated.
