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JAMA Surgery Clinical Challenge
February 15, 2017

Incidentaloma in the Right Iliac Fossa

Author Affiliations
  • 1Department of Surgical Gastroenterology, Max Super Speciality Hospital, Saket, New Delhi, India
  • 2Department of Radiology, Max Super Speciality Hospital, Saket, New Delhi, India
JAMA Surg. Published online February 15, 2017. doi:10.1001/jamasurg.2016.5552

A woman in her early 70s underwent laparoscopic right partial nephrectomy for oncocytoma. During workup, she was found to have an asymptomatic cystic lesion in the right iliac fossa. Fifteen months later, a contrast-enhanced computed tomographic (CT) scan of her abdomen showed a progressive 16-mm cystic lesion in close relation to the cecum (Figure 1). The rest of the colon and small intestine, as well as the adenexa, solid organs, and peritoneum, appeared normal. There was no other positive radiologic finding except for right partial nephrectomy. The general physical and abdominal examinations were unremarkable. The results of other investigations such as a hemogram, liver and kidney function tests, and serum tumor markers, including serum carcinoembryonic antigen levels (0.94 ng/mL [to convert to micrograms per liter, multiply by 1.0]), were within the prescribed normal range. She had good exercise tolerance, and the results of cardiopulmonary investigations, as a part of preanesthesia workup, were normal.

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