A mesh masquerading as malignancy: a cancer misdiagnosed

Area of Science:

• Gastroenterology
• Surgical Oncology
• Pathology

Background:

• A 60-year-old woman presented with a positive fecal occult blood test, prompting a screening colonoscopy.
• The colonoscopy revealed a suspicious ulcerated lesion in the ascending colon, raising concerns for malignancy.

Observation:

• Initial biopsies were inconclusive, and a CT scan showed a polypoid lesion.
• A multidisciplinary team recommended a right hemicolectomy due to the lesion's suspicious appearance.

Findings:

• Surgical resection of the ascending colon mass was performed.
• Histopathology confirmed the absence of malignancy, identifying inflamed granulation tissue with a foreign body reaction to surgical mesh from a prior incisional hernia repair.

Implications:

• This case highlights the importance of considering non-malignant causes, such as foreign body reactions to surgical mesh, in the differential diagnosis of colonic lesions.
• It underscores the potential for diagnostic challenges in differentiating inflammatory processes from malignancy based on imaging and initial biopsies.
• The successful outcome emphasizes the value of thorough histopathological examination in guiding patient management and avoiding unnecessary aggressive treatments.