Introduction We present a rare case of isolated cecal stricture secondary to excessive non-steroidal anti-inflammatory drugs (NSAIDs) use mimicking colonic mass on diagnostic imaging of the abdomen. Isolated Cecal Stricture Secondary to NSAIDs Use Mimicking Colonic Mass Pranav Patel 1 , Tejas Raiyani 1 , * Adey Hasan 1 , Antwan Atia 2 , Ravindra Murthy 3 , Mark Young 2 1 Department of Internal Medicine, 2 Department of Gastroenterology, East Tennessee State University 3 Department of Gastroenterology, James H Quillen VA Medical Center, Johnson City, TN, United States. Discussion • The effects of NSAIDs on the gastrointestinal system are well established. • NSAIDs were first reported to cause colonic stricture in 1989 and since then at least 50 cases has been reported. • The most common site is the proximal ascending colon. NSAIDs were described to cause diaphragmatic colonic stricture. • Patients who have NSAIDs induced colonic stricture can present with features mimicking colonic malignancy or can present acutely with perforation. We present a rare case of isolated cecal stricture caused by NSAIDs. Case Description • 55-year-old male presented with sharp right lower Abdominal pain of two days. • Pain was continuous and non-radiating without nausea, vomiting, fever, chills, hematochazia or malena. • H/o 1-2 firm bowel movements every day , good appetite with stable body weight. • PMH: HTN, Dyslipidemia, GERD and Tubular adenomatous colon polyps • Physical examination : Right lower quadrant and suprapubic tenderness. • Labs: WBC 12.3/ mcL , HgB 12.6 g/dL , Normal CMP, LFT, coagulation and iron studies • CT Scan Abdomen : Large 6.3X 5.6 cm mass replacing cecum suspicious for colon cancer. • Colonoscopy : Large circumferential ulcerated stricture in the cecum. • Biopsies : Ulcerated mucosa and underlying granulation tissue with prominent endothelial cells. • A cytokeratin AE1/3 stain did not show any infiltrating tumor cells in the ulcerated areas. • Upon further questioning of the patient, he has been taking 3 tablets of aspirin daily and goody’s powder twice daily chronically. • Patient was asked to avoid NSAIDs. References 1. Lang J, Price AB, Levi AJ, Burke M, Bjarnason I. Diaphragm disease: pathology of disease of the small intestine induced by non-steroidal anti-inflammatory drugs. J Clin Pathol 1988;41(5):516-526. 2. Klein M, Linnemann D, Rosenberg J. Non-steroidal anti-inflammatory drug-induced colopathy. BMJ Case Rep. 2011 Feb 8;2011. 3. Khan AZ, George K, DeFriend DJ. Nonsteroidal anti-inflammatory drug-induced colonic stenosis: an unusual cause of a right-sided colonic mass: report of a case. Dis Colon Rectum. 2003 Mar;46(3):403-5. 4. El Hajj I, Hawchar M, Sharara A. NSAID-induced colopathy: case report and review of the literature. J Med Liban. 2009 Oct-Dec;57(4):274-6. Colonoscopy showing Large circumferential ulcerated stricture in the cecum CT showing Large Mass replacing Cecum suspicious for colon cancer. * Presenter