QUESTION

A 49-year-old male patient was admitted to an internal medicine outpatient clinic with chief symptoms of weakness, vague abdominal pain, feeling of incomplete defecation, and weight loss. He had type 2 diabetes mellitus and had been taking oral antidiabetic since 2 years. His mother was diagnosed with colon cancer 2 years ago. There was no obvious finding on physical examinations. However, his laboratory tests revealed anemia with Hb levels of 9.3 g/dL and Htc value of 29.5.

The patient underwent full endoscopy scans. In the lower gastrointestinal scan, there was an ulcero-vegetan mass in the middle part of the descending colon. Upper gastrointestinal endoscopy findings revealed a pulsatile mass at corpus in the direction of great curvature causing extrinsic compression (Figure 1). Besides, an enhanced thoracoabdominal computed tomography (CT) was obtained.

What is your diagnosis?

ANSWER

CT examination shows a narrowing segment at descending colon accompanying asymmetric wall thickness compatible with the mass detected by endoscopy (Figure 2). Splenic artery was extremely tortuous and this tortuosity caused extrinsic compression at the distal part of...