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Giant aggressive mesenteric fibromatosis- a case report.
Anandaravi Bn1, Jagadish Kumar Cd2, Sreejith Ps2
1Associate Professor, Department of Surgery, Mysore Medical College and Research Institute , Karnataka, India .
Journal of Clinical and Diagnostic Research : JCDR
|April 11, 2015
Summary
Mesenteric fibromatosis is a rare tumor. This case study details the successful surgical excision of a large mesenteric fibromatosis in a young male, highlighting diagnostic and treatment approaches for this uncommon condition.
Area of Science:
- Oncology
- Surgical Pathology
Background:
- Fibromatosis, particularly mesenteric fibromatosis, represents a rare subset of soft tissue tumors, with aggressive fibromatosis affecting 2-4 individuals per million.
- Females are more frequently diagnosed with this condition, potentially due to hormonal influences such as estrogen acting as a growth factor.
Observation:
- A 24-year-old male presented with a one-month history of progressive abdominal distension and pain.
- Physical examination revealed a large (15x14 cm), firm, mobile intra-abdominal mass originating from the mesentery.
- Initial computed tomography (CECT) of the abdomen suggested a gastrointestinal stromal tumor (GIST).
Findings:
- Surgical exploration identified a giant mesenteric mass without infiltration of surrounding structures, which was completely excised.
- Histopathological analysis revealed a uniform band of spindle-shaped cells in fascicles within a collagenous stroma.
- Immunohistochemistry confirmed the diagnosis of fibromatosis, with positive Beta Catenin staining and negative results for CD117, CD34, and SMA.
Implications:
- This case underscores the importance of considering fibromatosis in the differential diagnosis of intra-abdominal masses, even when initial imaging suggests other pathologies like GIST.
- Complete surgical excision is the primary treatment modality for mesenteric fibromatosis.
- The favorable postoperative outcome in this case highlights the potential for successful management of large mesenteric fibromatosis with appropriate surgical intervention.
