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Peritoneal Cancer Mimicking Sclerosing Mesenteritis: A Case Report
Naoto Mouri1, Ryuichi Ohta2, Chiaki Sano3
1Community Care, Unnan City Hospital, Unnan, JPN.
Cureus
|February 11, 2022
Summary
This case highlights the challenge in distinguishing primary peritoneal cancer from sclerosing mesenteritis, especially when imaging is inconclusive. Advanced diagnostics like PET-CT and biopsy are crucial for accurate diagnosis and treatment of peritoneal malignancy.
Area of Science:
- Oncology
- Radiology
- Gastroenterology
Background:
- Peritoneal cancer and sclerosing mesenteritis share overlapping clinical and imaging features, complicating differential diagnosis.
- Computed tomography (CT) and magnetic resonance imaging (MRI) are often insufficient for definitive differentiation.
- Accurate diagnosis is critical as treatments and prognoses differ significantly.
Observation:
- A case report of an older woman presenting with acute abdominal pain initially diagnosed as sclerosing mesenteritis.
- Initial treatment with antibiotics, NSAIDs, and prednisolone provided temporary symptom relief.
- Persistent symptoms, elevated cancer antigen 125, and evolving CT findings prompted further investigation.
Findings:
- Positron emission tomography-CT (PET-CT) and subsequent biopsy confirmed primary peritoneal cancer.
- The patient's initial presentation and imaging mimicked sclerosing mesenteritis.
- Tamoxifen treatment showed transient efficacy, underscoring the complexity of the case.
Implications:
- This case underscores the importance of considering primary peritoneal cancer in patients with suspected sclerosing mesenteritis, particularly with atypical presentations or evolving findings.
- Highlights the limitations of conventional imaging in differentiating these conditions.
- Emphasizes the role of advanced imaging (PET-CT) and tissue biopsy in establishing a definitive diagnosis of peritoneal malignancy.
