An unusual cecal submucosal mass in an elderly gentleman

A 60-year-old male with previous hypertension was hospitalized because colonoscopy revealed a cecal submucosal mass during a community health examination 1 month previously. The patient has no symptoms such as poor appetite, fatigue, abdominal pain, diarrhea, nausea and vomiting. Laboratory tests and physical examination was unremarkable. A protrusion with multiple superficial small ulcers on the smooth surface measuring 1.5 × 2.0 cm was found beside the appendiceal orifice by colonoscopy. Abdominal computed tomography demonstrated a high-density mass without enhancement protruding towards the ileocecal cavity at the appendiceal orifice measured 1.5 × 1.8 cm. Laparoscopic ileocecal resection was performed because an appendiceal tumor could not be excluded and the patient strongly requested it. Pathology examination of the postoperative specimen revealed dilated appendix cavity with a fecalith inside the submucosal layer of the ileocecal region. The patient was diagnosed with an appendiceal orifice submucosal fecalith. He was discharged home uneventfully and no symptoms were observed during 3 months follow-up.