Crohn's Disease Mimicking an Ileum Tumor in an Elderly Patient: A Case Report

Background: Crohn’s disease is a chronic disease in which abnormal reactions of the immune system cause inflammation in the gastrointestinal tract. Most commonly, Crohn’s disease affects the small intestine and the beginning of the colon (ileocaecal junction). However, the disease may affect any part of the digestive tract, from the mouth to the anus. It can occasionally present as a tissular mass, mimicking neoplastic processes or a tumor like an Ileum mass, which is a rare localisation of tumors and it's frequently malignant. We share this case to underscore the importance of considering inflammatory causes in the differential diagnosis of bowel masses, even in elderly patients, and to highlight the significant histopathological examination which can reveal the real diagnosis.

Case report: Our case is about a 72-year-old male with a complex medical history who complained a year-long history of abdominal pain, vomiting, and constipation, provided in a relapsing-remitting evolution. Clinical and biological examinations was normal, but a CT scan revealed a small bowel tumor, localisated in the ileum. The patient benefited from a surgical cure, which revealed a tissue mass located 60 centimeters from the ileocecal junction. The tumor was resected, and an end-to-end anastomosis was performed. Unexpectedly, histopathological examination of the resected tissue confirmed the diagnosis of Crohn's disease instead of a malignant tumor.

Conclusion: Crohn's disease can present in various ways, and in this case, it imitated a malignant tumor both clinically and radiologically. This case undescores the importance of considering inflammatory intestine disease even in the case of an elderly patient.