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Extensive extraintestinal manifestations of ulcerative colitis in a patient initially suspected to have disseminated malignancy
  1. Nikolai Juul1,
  2. Stig Søgaard Dahl1,
  3. Deepthi Jermaly Chiranth2 and
  4. Luit Penninga1
  1. 1Department of Surgery and Transplantation, Rigshospitalet, Copenhagen, Denmark
  2. 2Department of Pathology, Rigshospitalet, Copenhagen, Denmark
  1. Correspondence to Dr Luit Penninga; LP{at}


A 44-year-old patient with known ulcerative colitis presented with abdominal pain and an abdominal mass. CT revealed cecal stranding, a mass at the left colonic flexure involving the pancreas and multiple lesions in the lungs, retroperitoneum and liver. The patient had also developed a scalp rash as well as impaired hearing. Biopsies from the abdominal mass and lungs revealed necrotic inflammation, and the clinical suspicion of malignancy could not be ruled out. After further examination, the patient was treated with high-dose steroids, which rapidly reduced the extraintestinal manifestations. Due to a persistent abscess formation at the left colonic flexure and pancreas, the patient was referred to our hospital for a total colectomy. Histology showed acute and chronic inflammation with cryptitis, indicating ulcerative colitis. Our case is a rare presentation of extensive extraintestinal disease in organs such as the lungs and liver, as well as necrotic mass formation at the colon site which mimicked malignancy.

  • ulcerative colitis
  • Crohn's disease
  • gastrointestinal surgery

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  • Contributors NJ and LP had the idea. NJ, SSD and DJC collected data. NJ and SSD prepared the first draft of the manuscript. SSD, DJC and LP critically revised the manuscript. All authors approved the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.