Sigmoid Schistosomiasis Granuloma Manifested as a Large Painless Supra-Pubic Mass: A Case Report

Schistosomiasis remains a prevalent parasitic disease in tropical and subtropical regions, ranking second to malaria in terms of parasitic burden. The disease manifests in two primary forms: urinary schistosomiasis, caused by Schistosoma haematobium, and intestinal schistosomiasis, associated with S. mansoni and S. japonicum. This case report describes a 12-year-old female from New Halfa, Sudan, who presented with a progressively enlarging lower abdominal mass. She had a prior history of S. mansoni infection, diagnosed and treated a year earlier. Clinical evaluation revealed a firm, mobile, non-tender suprapubic mass, while imaging studies identified a large abdominopelvic mass with mesenteric lymphadenopathy. Surgical exploration confirmed a sigmoid colon tumor, necessitating resection and anastomosis. Histopathological analysis revealed viable Schistosoma ova with granulomatous inflammation, confirming colonic schistosomiasis. The patient recovered well postoperatively and received praziquantel therapy. This case underscores the importance of early schistosomiasis treatment to prevent severe complications, including granuloma formation and intestinal obstruction. It also highlights the diagnostic challenges of intestinal schistosomiasis, which can mimic neoplastic conditions. Enhanced screening, timely praziquantel administration, and improved public health interventions are crucial in endemic areas to mitigate disease progression and long-term morbidity.