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A 49 year old male patient with a 23 year history of Crohn’s disease was admitted to our hospital for the appearance of an abdominal mass in the right upper quadrant of the abdomen. He reported the occurrence of abdominal distension and fullness for two weeks. Two years before he underwent ileocolic resection and six months later surgical treatment of a perianal localisation of his Crohn’s disease.
At admission, a large abdominal mass was found on physical examination. Pain was absent. Routine blood examination did not reveal abnormal values. Tumoral marker levels, including CEA and CA 19.9, were negative.
An abdominal ultrasound revealed a large (13 cm in diameter) right upper quadrant mass. A computerised tomography scan showed a bulky abdominal neoplasm, with sharp tumour margins and homogeneous density before and after intravenous contrast delivery.
A small bowel radiography was also performed (fig 1). What is the diagnosis?
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Robin Spiller, Editor
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