Mesenteric Fibromatosis Presenting as a Diagnostic Dilemma: A Rare Differential Diagnosis of Right Iliac Fossa Mass in an Eleven Year Old—A Rare Case Report

Mahajan, Abhinav; Singh, Mukhtiar; Varma, Anjali; Sandhu, Gunjeet Singh; Singh, Mandeep; Nagori, Rupesh

doi:10.1155/2013/569578

Cited by 6 publications

(16 citation statements)

References 9 publications

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“…Several case reports have been published whereby fibromatosis presents as an incidental or symptomatic abdominal mass [12,[16][17][18][19][20][21][22][23]. Some present as surgical emergencies with bleeding requiring emergency laparotomy [24,25].…”

Section: Discussionmentioning

confidence: 99%

Not all abdominal masses after colorectal cancer surgery are malignant: intra‐abdominal fibromatosis masquerading as recurrence

et al. 2019

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Aim Intra‐abdominal fibromatosis is an unusual mesenchymal tumour that can be locally aggressive without any metastatic potential. Fibromatosis may simulate cancer recurrence on imaging surveillance for colorectal cancer follow‐up. The optimal treatment of recurrent peritoneal malignancy is cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Confirmatory biopsy of lesions suspicious for colorectal cancer recurrence may not be feasible, thereby rendering surgery the safest option. Our aim was to determine the incidence of fibromatosis in a cohort of patients undergoing CRS and HIPEC for suspected colorectal cancer recurrence. Methods One hundred and seventy‐one CRS and HIPEC cases were performed at our Peritoneal Malignancy Institute between February 2007 and October 2018 for colorectal peritoneal metastases and were included in a prospectively maintained database. Results A total of 49 (29%) of 171 cases were performed for primary colorectal cancer with peritoneal metastases, whereas 122 (71%) of 171 cases were performed for suspected colorectal cancer recurrence detected on surveillance imaging after primary colorectal cancer resection. On histological analysis of the resected specimen, five (4.1%) of 122 cases undergoing CRS and HIPEC for colorectal recurrence had fibromatosis. Conclusion Fibromatosis can masquerade as colorectal cancer recurrence. In this series it occurred with an incidence of 4.1% among a cohort of patients undergoing CRS and HIPEC for probable recurrence. Surgical resection may be the only option to confirm the diagnosis and rule out malignancy.

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Section: Discussionmentioning

confidence: 99%

Not all abdominal masses after colorectal cancer surgery are malignant: intra‐abdominal fibromatosis masquerading as recurrence

et al. 2019

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“…Mesenteric fibromatosis (MF), also known as mesenteric desmoids, is part of the clinical-pathologic spectrum of deep fibromatoses which encompasses a group of benign fibroproliferative processes that are locally aggressive and have the capacity to infiltrate or recur without metastasis. They are classified according to their anatomical location, whether it is intra-abdominal, from the deep soft tissues of the abdominal wall, or deep within the extra-abdominal soft tissues [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, after extensive research, we found that a strong association has also been reported between desmoid tumors and familial adenomatous polyposis (FAP), especially Gardner’s syndrome [ 2 ]. Thirteen percent of patients with mesenteric fibromatosis have FAP, specifically the Gardner syndrome variant of FAP [ 1 ]. Therefore, patients with FAP and a family history of mesenteric desmoids have a greater than 25% chance of developing this tumor [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, patients with FAP and a family history of mesenteric desmoids have a greater than 25% chance of developing this tumor [ 2 ]. Additionally, 83% of patients with FAP and mesenteric fibromatosis have a history of abdominal surgery, most commonly a total colectomy [ 1 ]. Mesenteric fibromatosis mainly occurs in female patients (80% of cases) from 14 to 75 years of age (mean: 41 years), without any preference in race [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, 83% of patients with FAP and mesenteric fibromatosis have a history of abdominal surgery, most commonly a total colectomy [ 1 ]. Mesenteric fibromatosis mainly occurs in female patients (80% of cases) from 14 to 75 years of age (mean: 41 years), without any preference in race [ 1 ]. The female predilection is due to the fact that estrogen, even exogenous estrogen, is a factor that predisposes one to mesenteric fibromatosis and plays a role in its formation.…”

Section: Introductionmentioning

confidence: 99%

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Incidental Finding and Management of Mesenteric Fibromatosis

Nicolas¹,

Kfoury²,

Shimlati³

et al. 2016

Am J Case Rep

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Patient: Male, 45Final Diagnosis: Mesenteric fibromatosisSymptoms: —Medication: —Clinical Procedure: Surgical removal of the mesenteric fibromatosisSpecialty: SurgeryObjective:Rare diseaseBackground:Mesenteric fibromatosis, also known as mesenteric desmoids, is part of the clinical-pathologic spectrum of deep fibromatosis, which encompasses a group of benign fibro-proliferative processes that are locally aggressive and have the capacity to infiltrate or recur without metastasis.Case Report:Case of a 45-year-old man, with a history of hypertension and lung fibrosis, presenting for a left abdominal mass, which was found incidentally during his lung fibrosis imaging. He complained of constipation due to pressure upon his bowel leading to difficulty in defecation.Conclusions:Although there are many overlapping criteria between gastrointestinal stromal tumors and mesenteric fibromatosis, making it difficult to discriminate between the two, there are differences that are unique to mesenteric fibromatosis that should be noticed during the diagnosis. In this case, mesenteric fibromatosis was unusual as it is not associated with Gardner’s syndrome, desmoid tumors, nor familial adenomatous polyposis, but was an incidental finding.

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Rare acute abdominal condition caused by mesenteric fibromatosis perforation

Li¹,

Xu²,

Hu³

2019

Medicine

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Rationale:Mesenteric fibromatosis is a rare benign neoplasm with a tendency to spread and recur locally, without metastasis. It may present with a wide spectrum of clinical features; however, onset as a perforation is extremely rare.Patient concerns:The present patient was an 18-year-old female with a 10-hour history of increasing abdominal pain that arose suddenly with nausea and vomiting. She had experienced an appendectomy 2 years before this admission.Diagnoses:A gastrointestinal perforation was initially suspected on the basis of complaints and physical examination. The patient was thoroughly investigated for further diagnosis. Computed tomography showed a large well-defined intra-abdominal mass measuring 7.1 × 6.7 × 5.9 cm in the right lower quadrant, with adjacent small intestine compression and free intraperitoneal air. Then, the patient underwent a laparotomy. Finally, postoperative pathology and immunohistochemistry confirmed mesenteric fibromatosis, with a consecutive perforation from ileum to the bottom of tumor.Interventions:The patient has been treated by a resection of the mass with the adhesive small intestine, without chemotherapy or radiotherapy postoperatively.Outcomes:The patient had an uneventful postoperative recovery. Three months after surgery, the patient reviewed the colonoscopy, no intestinal polyps were noted. The present case has been followed up for 17 months without tumor recurrence.Lessons:Our case illustrates another possible cause of acute abdominal pain. Although rare, treating physicians should maintain a high suspicion index while managing a patient with an abdominal mass and pain. Close follow-up is essential because of the high incidence of local tumor recurrence.

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Mesenteric Fibromatosis Presenting as a Diagnostic Dilemma: A Rare Differential Diagnosis of Right Iliac Fossa Mass in an Eleven Year Old—A Rare Case Report

Cited by 6 publications

References 9 publications

Not all abdominal masses after colorectal cancer surgery are malignant: intra‐abdominal fibromatosis masquerading as recurrence

Not all abdominal masses after colorectal cancer surgery are malignant: intra‐abdominal fibromatosis masquerading as recurrence

Incidental Finding and Management of Mesenteric Fibromatosis

Rare acute abdominal condition caused by mesenteric fibromatosis perforation

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