Intestinal Behçet’s Disease Presenting as a Tumor on CT-Scan: A Report of an Intriguing Case

Abstract

Introduction: Behçet’s Disease is a multisystem vasculitis of unknown origin that may affect any organ, causing small-vessel vasculitis. Given that there is no specific test, the diagnosis BD is based on clinical criteria. When the gastrointestinal tract is affected, it presents usually with abdominal pain. In case of surgical treatment, the histopathological examination usually reveals small vein vasculitis and nonspecific inflammation. Otherwise, corticosteroids and immunosuppressive drugs are used. In this report, we present a case of Intestinal Behçet’s Disease showing features of malignancy on CT-scan. Case Presentation: A 67-year-old woman, with known history of oral BD under treatment, presented at the Emergency Department complaining of low-grade fever and pain at the right iliac fossa. CT scan revealed a possible tumor in the caecum and partial stenosis of terminal ileum. Right hemicolectomy and right adnexectomy were performed. On gross examination an area of flattened caecal mucosa was revealed, the microscopical examination of which revealed extensive mucosal ulceration, transmural inflammation and abscesses. Furthermore, there was marked oedema and many congested vessels all over the intestinal wall as well as in the fallopian tube and ovary. All these findings, in combination with patient’s history and the rest of clinical, imaging and laboratory tests lead us to the diagnosis of Intestinal Behçet’s Disease. Conclusion: BD is an autoimmune disorder that may involve the gastrointestinal tract. The diagnosis of this disease should be based on clinical criteria since the results of laboratory or radiological investigations are not specific and may indicate erroneously other conditions.