Malignant masquerade sclerosing mesenteritis: A case report and review

Area of Science:

• Gastroenterology
• Pathology
• Surgical Oncology

Background:

• Mesenteric panniculitis (MP), also known as sclerosing mesenteritis, is a rare inflammatory condition affecting mesenteric adipose tissue.
• Its etiology remains unknown, and it is infrequently diagnosed.

Purpose of the Study:

• To present a case of sclerosing mesenteritis (SM) that mimicked a malignant lesion.
• To underscore the importance of histopathological confirmation in differentiating SM from abdominal malignancies.

Main Methods:

• Case presentation of a 68-year-old male with abdominal pain, fever, and constipation.
• Diagnostic workup included contrast-enhanced computed tomography (CECT) and positron emission tomography/computed tomography (PET/CT).
• Surgical management involved radical excision of the mesentery with bowel resection, followed by histopathological analysis.

Main Results:

• CECT and PET/CT revealed a mesenteric mass with features suggestive of malignancy.
• Histopathology confirmed the lesion as sclerosing mesenteritis, characterized by fibroblast proliferation, dense fibrosis, mature fat cells, and lymphocytic infiltrate.
• The patient underwent successful surgical resection and is currently under follow-up.

Conclusions:

• Sclerosing mesenteritis can present with imaging findings indistinguishable from malignant tumors.
• Accurate histopathological examination is crucial for the definitive diagnosis of mesenteric panniculitis.
• Early surgical intervention may be necessary for symptomatic cases, even when benign.