Mesenteric fibromatosis misdiagnosed with lymph node metastasis after successful laparoscopic right hemicolectomy: a report of two cases with review of literature

Abstract

Fibromatosis is a rare type of tumor derived from the mesenchymal tissue. This is a benign tumor with infiltrating growth but may invade locally and recur following excision. As one type of fibromatosis, mesenteric fibromatosis (MF) accounts for a mere 8% of cases. Although studies have revealed that the etiology of MF is related to trauma, surgery, hormones, and heredity, the specific etiology of fibromatosis remains unclear. With such low incidence, MF has been rarely reported and tends to be misdiagnosed due to insufficient recognition. In this paper, we describe the cases of two patients with MF who were misdiagnosed with lymph node metastasis and who had previously undergone successful laparoscopic right hemicolectomy. We provide this information in order to broaden the clinical understanding of MF.

Mesenteric Fibromatosis: A Case Report

“…It is commonly seen in reproductive years of women, often during and after pregnancy. Desmoid tumors (DT) are histologically benign, but they may show local recurrence after excision [2].…”

A giant mesenteric fibromatosis adherent to the appendix and colonic wall, case report

“…Mesenteric fibromatosis (MF), is a rare tumor, derived from the mesenchymal tissue [ 2 ], they are considered a proliferation of fibroblasts and myofibroblasts [ 3 ] with uniformly bland nuclear features [ 4 ]. It have an intermediate behavior between fibrosarcomas and benign fibrous neoplasm [ 3 ], This behavior is characterized by local aggressive invasion, but without metastasizing potential [ 3 , 2 ].…”

“…MF accounts for 0.03% of all neoplasms and 3% of soft tissue tumours [ 5 ] and 8% of fibromatosis [ 2 ], which rarely arise from the mesentery and abdominal organs, but instead they often arises from the extremities or the abdominal wall [ 4 ]. MF is considered as the most common primary tumor of the mesentery arises most frequently in the retroperitoneum or in the small bowel mesentery, but they rarely involve the omentum and mesocolon [ 3 ].…”

“…They occur especially in the 3rd and 4th decades, but they can arise in all ages [ 3 ]. It can be sporadic or hereditary as in the case of Gardner's syndrome [ 2 ], that why patients diagnosed with intra-abdominal fibromatosis should be screened for familial adenomatous polyposis (FAP) endoscopically [ 6 ].…”

“…Patients usually presents with painless abdominal mass [ 2 ] and they are commonly large around 10 cm at presentation [ 5 ]. Symptoms are caused by the compression and infiltration of the adjacent organs as the tumor develop [ 3 ] and according to their size and location, they can progress to an ischemia, bowel obstruction [ 2 ], small bowel fistula formation, gastrointestinal bleeding and abscess formation [ 6 ].…”