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Mesenteric fibromatosis presenting as fever of unknown origin
1Department of Internal Medicine, Hyogo Medical Center for Adults, Japan.
Abstract:
We report a case of fibromatosis, soft tissue tumors that are benign histologically, but exhibit behavior intermediate between benign and malignant diseases. Mesenteric fibromatosis grows vigorously without a general inflammatory reaction, and its symptoms are the result of obstruction and/or compression of the intestine. However, in our case, the general inflammatory reactions of fever and C-reactive protein (CRP) elevation was present at an early stage. Because this inflammatory reaction disappeared after surgical resection, it may have been induced by some inflammatory factors produced in the tumor, such as those produced in inflammatory fibrous histiocytoma. We found that computed tomography was useful in the detection of the cause of fever of unknown origin, and suggest that it should be recommended in cases of long-lasting unexplainable fever.
Insights
This case study highlights mesenteric fibromatosis, a soft tissue tumor, presenting with unusual inflammatory symptoms like fever and elevated C-reactive protein (CRP). Computed tomography aided in diagnosing this rare cause of prolonged fever.
Area of Science:
- Oncology
- Gastroenterology
- Pathology
Background:
- Mesenteric fibromatosis comprises benign soft tissue tumors with intermediate behavior between benign and malignant conditions.
- Typically, these tumors grow without systemic inflammatory reactions, with symptoms arising from intestinal obstruction or compression.
Observation:
- A unique case presented with early-stage inflammatory responses, including fever and elevated C-reactive protein (CRP).
- These inflammatory markers resolved post-surgical resection of the mesenteric fibromatosis.
- The inflammatory reaction may have been triggered by tumor-produced factors, similar to those in inflammatory fibrous histiocytoma.
Findings:
- Computed tomography (CT) proved effective in identifying the source of unexplained fever in this patient.
- The presence of systemic inflammation (fever, elevated CRP) was an atypical presentation for mesenteric fibromatosis.
Implications:
- CT imaging is recommended for diagnosing the cause of persistent, unexplained fevers, especially when other causes are ruled out.
- This case expands the understanding of potential inflammatory presentations of mesenteric fibromatosis.
- Further research into tumor-induced inflammatory factors could offer new diagnostic or therapeutic insights.