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A 37-year-old man presented with a 2-week history of crampy abdominal pain and bloating. This was associated with vomiting, loss of appetite and absolute constipation. He was otherwise fit and well with no medical or family history of note. CT imaging showed large bowel obstruction with a transition point 10 cm from the splenic flexure. There were areas within the lesion with the same attenuation as bone. Flexible sigmoidoscopy showed an obstructing tumour 65 cm from the anal verge. A laparotomy and resection were performed. The histology of the transverse colon tumour is shown (see figure 1).
Review the high quality, interactive digital Aperio slide at http://virtualacp.com/JCPCases/jclinpath-2019-206130/ …
Handling editor Iskander Chaudhry.
Contributors All authors contributed to the conception, writing and revising of this manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Obtained.
Provenance and peer review Commissioned; internally peer reviewed.