Sclerosing mesenteritis mimicking metachronous peritoneal metastases from descending colon adenocarcinoma

Abstract

BackgroundSclerosing mesenteritis is a non-neoplastic inflammatory disease that occurs in the bowel mesentery. Distinguishing sclerosing mesenteritis from neoplasms may be difficult because of the clinical and radiographic similarities between the two disease entities.Case presentationWe report a case of sclerosing mesenteritis mimicking peritoneal metastases of colorectal carcinoma. A 73-year-old man with stage II descending colon adenocarcinoma with poor prognostic features was found to have developed left lower abdominal quadrant masses on computed tomography (CT) 9 months after undergoing radical surgery. These masses were diagnosed as peritoneal metastases because they grew in size and displayed fluorodeoxyglucose (FDG) uptake 3 months later; thus, a laparotomy was performed. The masses, which were localized in the jejunal mesentery, were excised completely via segmental jejunal resection. Histopathological analysis confirmed that the masses were sclerosing mesenteritis. The patient showed no signs of sclerosing mesenteritis or colorectal carcinoma recurrence during follow-up.ConclusionsIn patients suspected of having localized peritoneal metastasis from malignancies, any masses must be sampled by surgical excisional biopsy and subsequently examined to rule out alternative diagnoses, such as sclerosing mesenteritis.

Idiopathic Sclerosing Mesenteritis: An Extremely Rare Cause of Mesenteric Mass

“…It may show fibrosis, inflammation, and fat necrosis and occasionally lipid-laden foamy macrophages may be found infiltrating the mesenteric fat [ 4 ]. Histopathology also helps in ruling out peritoneal carcinomatosis which might have similar CT appearance as sclerosing mesenteritis [ 8 ]. Before terming it as “idiopathic sclerosing mesenteritis”, common causes like autoimmune diseases, abdominal trauma, and IgG4-related diseases need to be excluded [ 9 ].…”

18F-FDG PET/CT Imaging of Peritoneal Fibrosis Mimicking Persistent Metastatic Ovarian Carcinoma

“…It also emphasizes the concept that inflammatory peritoneal lesions can persist for a long time in a random way and hypermetabolic foci should be extensively investigated before therapeutic decision. Indeed, a variety of 18 F-FDG-avid physiological, benign (inflammatory and/or infectious), or malignant conditions can be involved in the peritoneum [1][2][3][4][5]. No quantitative uptake cut-off can be used for differential diagnosis, because inflammatory lesions also exhibit high 18 F-FDG uptake due to the overexpression of GLUT-1 in macrophages [6].…”