An Unusual Colonic Mass in a Young Woman

A previously healthy 40-year-old woman was hospitalized with abdominal pain of 10 days duration. Abdominal computed tomography revealed a mass in hepatic flexure of colon, demonstrating fat density in the center with equal density at the edge. Intestinal wall around the mass was swollen, expanded, and nested (Figure A). There was no enhancement observed in the center, whereas slight continuous enhancement at the edge of the mass was detected in re-examined enhanced abdominal computed tomography after conservative treatment (Figure B). Right hemicolectomy was performed. A palpable mass in the ascending colon, small amount of ascites, and no metastatic nodules were found in the abdomen during the operation. Histopathology examination of the resected specimen showed a polypoid mass in ascending colon measured 4.0 × 5.0 × 6.0 cm. Proliferative mature adipose tissue, thick-walled blood vessels, spindle cells, and epithelioid cells were found in the submucosa of the mass. Spindle cells were arranged in bundles. Epithelioid cells, which with slightly larger cells and abundant, pink-staining cytoplasm, surrounded the blood vessels (Figure C). The immunohistochemical analysis for HMB-45 (Figure D), Melan-A, Desmin, and S-100 was positive; CKpan was negative. The final diagnosis was colonic perivascular epithelioid cell tumor. The patient was discharged home uneventfully and remained asymptomatic in 2 years follow-up. CorrectionClinical Gastroenterology and HepatologyVol. 21Issue 5PreviewTang Y, Liu D, Zhen Z. An Unusual Colonic Mass in a Young Woman. Clin Gastroenterol Hepatol 2023;21:A16. Full-Text PDF