Song SH, Lee SS, Kim DJ. Transverse colon foreign body-associated reactive mass mimicking gastrointestinal stromal tumors: A case report. World J Gastrointest Surg 2026; 18(4): 116972 [DOI: 10.4240/wjgs.v18.i4.116972]
Corresponding Author of This Article
Seung Soo Lee, MD, PhD, Department of Surgery, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu 41944, South Korea. peterleess@hanmail.net
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Surgery
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Case Report
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Apr 27, 2026 (publication date) through Apr 24, 2026
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World Journal of Gastrointestinal Surgery
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1948-9366
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Song SH, Lee SS, Kim DJ. Transverse colon foreign body-associated reactive mass mimicking gastrointestinal stromal tumors: A case report. World J Gastrointest Surg 2026; 18(4): 116972 [DOI: 10.4240/wjgs.v18.i4.116972]
World J Gastrointest Surg. Apr 27, 2026; 18(4): 116972 Published online Apr 27, 2026. doi: 10.4240/wjgs.v18.i4.116972
Transverse colon foreign body-associated reactive mass mimicking gastrointestinal stromal tumors: A case report
Seung Ho Song, Seung Soo Lee, Dong Ja Kim
Seung Ho Song, Seung Soo Lee, Department of Surgery, Kyungpook National University Hospital, Daegu 41944, South Korea
Seung Ho Song, Seung Soo Lee, Department of Surgery, School of Medicine, Kyungpook National University, Daegu 41944, South Korea
Dong Ja Kim, Department of Forensic Medicine, School of Medicine, Kyungpook National University, Daegu 41944, South Korea
Author contributions: Song SH and Lee SS were attending doctors for the patient; Song SH and Lee SS performed the surgery; Kim DJ performed the pathological examination; Song SH wrote the draft. All authors performed the literature review. All authors designed the report. All authors revised the manuscript. All authors read and approved the final manuscript.
Supported by Biomedical Research Institute Grant, Kyungpook National University Hospital; No. 2025; and Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), Funded by the Ministry of Health & Welfare, Republic of Korea, No. RS-2022-KH130590.
Informed consent statement: The patient provided written informed consent at the first postoperative outpatient visit for publication of all clinical details and images included in this case report.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Seung Soo Lee, MD, PhD, Department of Surgery, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu 41944, South Korea. peterleess@hanmail.net
Received: November 26, 2025 Revised: January 8, 2026 Accepted: January 26, 2026 Published online: April 27, 2026 Processing time: 150 Days and 2.1 Hours
Abstract
BACKGROUND
Foreign body-associated reactive masses may appear months to decades after abdominal surgery and often present as well-circumscribed lesions on imaging studies. Their radiological features frequently mimic gastrointestinal stromal tumors (GISTs) or other malignant intra-abdominal neoplasms. While most reported postoperative foreign body reactions arise in the peritoneal cavity or mesentery, reactive masses originating from the colonic wall are exceptionally rare. Large colonic lesions presenting many years after surgery further complicate diagnosis.
CASE SUMMARY
A 38-year-old man with a history of open appendectomy 20 years prior was incidentally found to have a 9-10 cm intra-abdominal mass on a subsequent computed tomography (CT) screening. Contrast-enhanced CT presented a well-circumscribed lesion with marked central low attenuation and peripheral enhancement, strongly suggestive of a GIST in the small bowel. Exploratory laparotomy revealed a firm, heterogeneous mass densely adherent to adjacent structures and arising from the transverse colon. Thus, segmental transverse colectomy with stapled anastomosis was performed. Histopathological examination showed extensive fibrosis, necrosis, and old hemorrhage with a chronic foreign body-type reactive process and no neoplastic features. No grossly identifiable foreign material was detected, although microscopic findings supported a chronic foreign body reaction. Postoperative recovery was uneventful aside from a brief readmission for transient ileus.
CONCLUSION
Colonic foreign body-associated reactive masses can mimic GISTs decades after surgery and should be considered in patients with prior abdominal operations.
Core Tip: We report a rare case of a large foreign body-associated reactive mass presenting 20 years after surgery for perforated appendicitis. The lesion mimicked a gastrointestinal stromal tumor on contrast-enhanced computed tomography, leading to diagnostic uncertainty. Surgical resection and histopathological evaluation revealed a chronic foreign body-type inflammatory reaction, in which microscopic foreign materials were identified despite the absence of a grossly identifiable foreign body. This case illustrates a potential diagnostic pitfall and emphasizes the need to consider postoperative inflammatory and foreign body-associated lesions in the differential diagnosis of large intra-abdominal masses.
