Masquerade in the Cecum

A BSTRACT We present the case of a 38-year-old male with right lower abdominal pain, initially diagnosed as an appendicular abscess via ultrasonography. Intraoperative findings revealed a firm 7 cm × 5 cm mass arising from the cecal wall, raising suspicion of malignancy, with the appendix not visualized. Given the patient’s young age and lack of preoperative evidence of carcinoma, an incisional biopsy was performed instead of radical resection. Histopathology revealed fat necrosis, ruling out malignancy. This conservative approach prevented unnecessary morbidity from major procedures such as right hemicolectomy or ileostomy. This case underscores the importance of cautious intraoperative decision-making and histopathological confirmation in atypical intra-abdominal masses to avoid overtreatment, particularly in young patients.