Caecal amoeboma simulating malignant neoplasia, ileocaecal tuberculosis and Crohn's disease

ABSTRACT

We report two cases of amoeboma of caecum. The patients were initially diagnosed with acute appendicitis but a large cecal mass was found on surgery, giving the gross impression of tumor, Ileocaecal tuberculosis or Crohn's disease necessitating right hemicolectomy. On histopathological examination, the mass was found to be 'Amoeboma'. Mode of presentation, clinical examination and operative findings are presented along with the review of literature. A 39 years old woman presented to the surgical outpatient department with complaints of right lower abdominal pain and fever for 2 days. Pain was localized to right iliac fossa. It was continuous and severe in intensity with no aggravating or relieving factors. The patient had intermittent fever upto 101 F. On clinical examination, the right iliac fossa was markedly tender. Total leukocyte count was 12.6 x 109 /L. A clinical diagnosis of acute appendicitis was made. Peroperatively, a focal inflammed caecal mass was found, grossly appearing like Crohn's disease. Rest of the abdomen was normal. Limited right hemicolectomy was done. Distal 6 inches of ileum along with proximal ascending colon was resected and an end to end anastomosis made. The postoperative recovery remained uneventful. Histopathological examination of the resected specimen turned out to be caecal amoeboma