Benign Mesenteric Lesion Presenting with Features of a Malignant Mass

Area of Science:

• Gastroenterology
• Radiology
• Pathology

Background:

• Encapsulated fat necrosis (EFN) is often asymptomatic but can manifest as acute abdominal pain.
• Mesenteric fat necrosis falls under the spectrum of mesenteric sclerosis.
• EFN masses can be misdiagnosed as liposarcoma, cecal carcinoma, or epiploic appendagitis.

Observation:

• An 82-year-old male presented with an asymptomatic right lower quadrant mass.
• Computed tomography revealed concerning findings.
• The patient had no prior abdominal surgery or trauma.

Findings:

• The case highlights the diagnostic challenge of EFN.
• EFN can mimic serious intra-abdominal pathologies.
• Distinguishing EFN from malignancy and sclerosing mesenteritis is critical.

Implications:

• Accurate diagnosis of EFN prevents misdiagnosis and inappropriate aggressive management.
• Understanding EFN's mimicry is vital for surgical and oncological decision-making.
• This case underscores the importance of considering benign conditions in abdominal mass evaluation.