# Chronic Idiopathic Ulcers Mimicking Cecal Carcinoma: A Case Report

## TL;DR

A 68-year-old woman's chronic idiopathic ulcers were initially mistaken for cecal carcinoma, showing the diagnostic challenges of this condition.

## Contribution

This case report highlights the diagnostic difficulty of chronic idiopathic ulcers mimicking cecal carcinoma.

## Key findings

- Chronic idiopathic ulcers can resemble cecal carcinoma and other intestinal pathologies.
- Histological examination revealed inflammatory cells and scar tissue in the ulcer bed.
- The case underscores the need to consider chronic idiopathic ulcers in differential diagnoses of cecal masses.

## Abstract

Chronic idiopathic ulcers of the colon pose diagnostic challenges due to their elusive etiology and potential resemblance to other intestinal pathologies, such as cecal carcinoma. This case report outlines the clinical course of a 68-year-old female patient who presented to the emergency department (ED) with persistent right lower quadrant pain. Despite multiple hospital visits yielding varied diagnoses, a definitive diagnosis was only made following a laparoscopic partial colectomy, which revealed chronic idiopathic ulcers with transmural scarring and adhesions to adjacent small intestine loops. Histological examination demonstrated a substantial ulcer bed populated by inflammatory cells, including large stellate and spindled stromal cells within the granulation tissue, alongside lymphoid hyperplasia and scar tissue extending into the muscularis propria. The initial presentation of this case could easily be mistaken for appendicitis, diverticulitis, carcinoma, or irritable bowel syndrome, highlighting the significance of considering chronic idiopathic ulcers in the differential diagnosis of patients presenting with cecal masses.