Clinical Snapshot
Ameboma—a Rare Differential Diagnosis of Cecal Cancer
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A 79-year-old female dialysis patient developed acute pain in the right abdomen. Ultrasound revealed cecal wall-thickening over a long segment, which on computed tomography (CT), was suggestive of carcinoma (Figure a). Colonoscopy yielded findings that were comparatively untypical for carcinoma (Figure b). Histology identified ulcerative colitis with amebic trophozoites in PAS staining. Thus, Entamaeba histolytica infection was confirmed and the diagnosis of ameboma made. This form of amebiasis is seen in approximately 1.5% of cases. Our patient’s medical history was uncharacteristic, since she had never traveled to an edemic area, with the exception of Italy (20 years previously). However, long-term dialysis as well as systemic treatment for psoriasis are associated with an increased susceptibility to infection. Infection-related symptoms were presumably concealed due to known irritable bowel syndrome. Amebiasis is treated with metronidazole (3 × 10 mg/kg bw/day intravenously or orally) followed by paromomycin (25–30 mg/kg bw/day in three single oral doses), each for 10 days. This produced a rapid improvement in our patient.
Dr. med. Sandrina Thiesen, St. Franziskus Hospital Münster, Sandrina.thiesen@gmail.com
Dr. med. Martin W. Baumgärtel, Klinik für Innere Medizin I, Nephrologie und Dialyse, Hypertensiologie, Rheumatologie und Osteologie, St. Franziskus Hospital Münster
Prof. Dr. med. Bernhard Glasbrenner, Klinik für Innere Medizin II, Gastroenterologie, Onkologie, Diabetologie, Infektiologie, St. Franziskus Hospital Münster
Conflict of interest statement: The authors state that no conflict of interest exists.
Translated from the original German by Christine Rye.
Cite this as: Thiesen S, Baumgärtel MW, Glasbrenner B: Ameboma—a rare differential diagnosis of cecal cancer. Dtsch Arztebl Int 2024; 121: 824a. DOI: 10.3238/arztebl.m2024.0155
Photo: Prof. Christoph Bremer, Radiologie,
St. Franziskus-Hospital Münster, Germany
