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Nodular Sclerosing Mesenteritis: An Occasional Finding Mimicking a Spindle Cell Tumor
Giovanna Brancato1, Marcello Donati1, Lucia Salvatorelli2
1Department of Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy.
The American Journal of Case Reports
|November 27, 2021
Summary
Sclerosing mesenteritis, a rare idiopathic disease, can be incidentally diagnosed during hernia surgery. Pathologists must distinguish it from aggressive tumors like desmoid fibromatosis.
Area of Science:
- Gastroenterology
- Pathology
- Abdominal Surgery
Background:
- Sclerosing mesenteritis is a rare idiopathic condition affecting the mesentery, characterized by inflammation, fat necrosis, and fibrosis.
- It presents as thickening of the mesentery, potentially causing symptoms like intestinal obstruction.
Observation:
- An 83-year-old woman presented with symptoms of intestinal occlusion, vomiting, and abdominal pain.
- Radiological imaging revealed signs of strangulated inguinal hernia with ileal obstruction.
Findings:
- Surgery for inguinal hernia reduction revealed ischemic ileal segments.
- Histological examination confirmed chronic inflammation and a fibrous nodule, leading to a diagnosis of sclerosing mesenteritis.
Implications:
- This case highlights the potential for incidental diagnosis of sclerosing mesenteritis during unrelated abdominal surgeries, such as hernia repair.
- Accurate pathological differentiation from tumors like desmoid-type fibromatosis and gastrointestinal stromal tumors is crucial.
