A TROJAN HORSE NEVER TO BE MISSED IN ELDERLY – AN INTRESTING CASE OF RIGHT ILIAC FOSSA MASS

Abstract

We report a case of an elderly patient presenting with the right iliac fossa mass. The provisional diagnosis included an inammatory appendicular mass or abdominal wall mass. Interestingly, initial non-contrast computed tomography (CT) of the abdomen and pelvis, lap parameters and colonoscopy guided biopsy demonstrated the inammatory changes. Follow up imaging by contrast CT threw light on a new path towards the neoplastic etiology. Even after the follow up imaging the subsequent colonoscopy guided biopsy showed features suspicious for malignancy whereas cystoscopy guided biopsy showed benign features. Intra-operatively bowel neoplasm with bladder invasion was seen and right hemicolectomy with partial cystectomy done. Post-operative specimen nally revealed mucinous adenocarcinoma of caecum with urinary the bladder invasion. In the presented case, non-contrast CT ndings and clinico-pathological reports suggestive of a benign etiology were misleading. This could have been prevented if the patient was subjected to contrast study in view of her elderly age. This case highlights the importance of imaging in patient management. Therefore, we feel that it is important to share our experience of the successful management of the presented case.