A case of early manifestation of pseudotumor of the sigmoid colon

Objective. To highlight the diagnostic challenges and present the successful surgical management of a sigmoid colon pseudotumor complicated by intussusception and bleeding in a young adult. Clinical case. A 20-year-old male was urgently admitted with blood in the stool. Colonoscopy revealed an 8-cm ulcerated submucosal lesion of the sigmoid colon without active bleeding. His condition improved on conservative therapy, and he declined further treatment, but within 24 hours developed abdominal pain and obstructive symptoms, prompting re-evaluation. Colonoscopy and contrast-enhanced CT suggested a sigmoid tumor complicated by intussusception and partial large-bowel obstruction. After multidisciplinary review, laparoscopic resection of the left colon with D2 lymphadenectomy and a hand-sewn side-to-side descendo-sigmoid anastomosis was performed. A 7.5×4.0×4.0 cm pedunculated lesion was removed. Histology showed no atypia; microscopically, the lesion consisted of spindle-cell proliferation in the submucosa, consistent with an inflammatory fibroid polyp (inflammatory pseudotumor). Conclusion. This clinical case of pseudotumor presenting as sigmoid colon intussusception in a 20-year-old patient illustrates a rare pattern of complications in this age group. It also underscores the importance of the ability of a multidisciplinary team to make non-standard management decisions to improve the quality of life of patients with rare colonic diseases.