An unusual case of fever and a sigmoid mass
- Tamara Kubba1,
- Mio Takatsuka2,
- Eve Stern1,
- Thomas Smith1,
- Jason Lee1,
- Maitham Al-Whouhayb1,
- Michael Saunders1
- 1Department of General Surgery, Barnet Hospital, Herts, UK
- 2Department of Surgery, Barnet and Chase Farm Hospitals, Herts, UK
- Correspondence to Dr Mio Takatsuka,
A 52-year-old Afro-Caribbean female presented with a 2-week history of left iliac fossa pain and persistent fever. The working diagnosis was diverticulitis and she was treated with intravenous antibiotics. A CT scan of the abdomen showed a thickened sigmoid colon lying adjacent to the left bladder wall with inflammatory changes present. As the patient’s condition showed no improvement, an explorative laparotomy was performed, which identified a mass in the sigmoid colon adherent to the bladder and left ovary. An anterior resection, partial cystectomy and a defunctioning loop-ileostomy were performed. Postoperatively, spiking fever with a high white cell count continued. No postoperative surgical complications were identified despite numerous investigations. Eventually, histology of the colon revealed a null type anaplastic large cell lymphoma with a high proliferation fraction of greater than 90%.
Competing interests None.
Patient consent Obtained.