Intestinal Wall Mass: Always Tumoral?

Background: Intestinal wall thickening with a mass-like appearance often raises suspicion for malignancy. However, inflammatory and lymphoproliferative disorders can present similarly, leading to diagnostic challenges. Case Presentation: We report two cases of intestinal pseudo-tumoral masses with distinct etiologies. The first case involved a 30-year-old male presenting with chronic abdominal pain and bowel disturbances. Imaging revealed a circumferential thickening of the ileocecal region, mimicking a stenosing mass. A right hemicolectomy was performed, and histopathology confirmed Crohn’s disease in an acute flare. The second case concerned a 43-year-old diabetic male with chronic abdominal pain and subocclusive episodes, progressing to acute intestinal obstruction. Imaging and intraoperative findings revealed an infiltrative mass in the terminal ileum. Histopathological analysis confirmed a B-cell marginal zone lymphoma. Conclusion: These cases highlight the importance of considering inflammatory and lymphoproliferative disorders in the differential diagnosis of intestinal masses. A multidisciplinary approach combining imaging, endoscopy, and histopathology is essential for accurate diagnosis and appropriate management.