Published online Oct 27, 2023. doi: 10.4240/wjgs.v15.i10.2362
Peer-review started: July 4, 2023
First decision: August 4, 2023
Revised: August 18, 2023
Accepted: August 31, 2023
Article in press: August 31, 2023
Published online: October 27, 2023
Processing time: 114 Days and 22.3 Hours
Epstein–Barr virus (EBV)-positive mucocutaneous ulcers (MCUs) are an un
The patient presented with an incidental finding of a small bowel tumor during computed tomography (CT) examination performed for hematuria. The CT scan showed irregular thickening of the distal ileum, which was suggestive of a malignant small bowel tumor. An exploratory laparotomy revealed an 8-cm mass in the distal ileum; thus, a segment of the small intestine, including the mass, was resected. Histopathological analysis revealed an ulceroinfiltrative mass-like lesion with luminal narrowing, marked inflammatory cell infiltration, and large atypical lymphoid cells (positive for EBV-encoded small RNA). A final diagnosis of an EBV-MCU was established. The postoperative course was uneventful, and the patient was discharged on postoperative day 7. The patient remained recurrence-free until 12 mo after surgery.
This case highlights the diagnostic challenges for EBV-MCUs and emphasizes the importance of comprehensive evaluation and accurate histopathological analysis.
Core Tip: We report a case that highlights the diagnostic challenges of distinguishing an Epstein–Barr virus-mucocutaneous ulcer from a small bowel adenocarcinoma in a 69-year-old woman. It emphasizes the importance of performing comprehensive evaluation and accurate histopathological analysis to guide appropriate management. Awareness of this rare entity is crucial for its timely diagnosis and prevention of unnecessary invasive procedures.