Inflammatory cecal tumor simulating Crohn's disease: A report of two cases.

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We experienced two cases of non-specific inflammatory cecal tumor occuring long after appendectomy. Case 1 was a 22-year-old male with periumbilical pain. Barium enema study showed narrowing with a crowded granular appearance of the ascending colon and cecum. Case 2 was a 54-year-old male with pain in the right lower quadrant of the abdomen. Barium enema study and colonoscopy showed narrowing with a cobbleston-like appearance of the ascending colon. Both patients were thought to have Crohn's disease. Medical treatment consisted of oral medication, but there was no improvement of the symptoms or stenosis. Right hemicolectomy was therefore performed because of remaining stenosis. In both cases, the surgical specimen showed crowded inflammatory polyps and histological findings included transmural inflammation and non-caseating granuloma. As Crohn's disease was suspected, the two cases were closely followed up. No recurrence has been recognized for 12 years in case 1 and for 5 years in case 2. Consequethy, it seems reasonable to assume that these inflammatory changes were secondary to appendectomy, probably due to rest abscess. We must therefore keep such cases in mind when we encounter ileocecal protuberant lesions.
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