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Multifocal Mesenteric Desmoid-Type Fibromatosis After Liver Transplantation: A Case Report
Ning Zhang1, Yuqing Du1, Meng Wang2
1Department of Ultrasound, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
The American Journal of Case Reports
|November 19, 2025
Summary
This case report details an incidental finding of multifocal desmoid-type fibromatosis (DTF) in a liver transplant patient. Comprehensive histopathology was crucial for differentiating DTF from other abdominal masses.
Area of Science:
- Oncology
- Pathology
- Gastroenterology
Background:
- Desmoid-type fibromatosis (DTF) is a rare, locally aggressive mesenchymal neoplasm often involving the mesentery.
- Intra-abdominal DTF presents diagnostic challenges due to overlapping imaging features with gastrointestinal stromal tumors (GISTs) and sarcomas.
- High recurrence rates necessitate accurate diagnosis and understanding of aggressive biological behavior, such as multifocal lesions.
Purpose of the Study:
- To report an incidental diagnosis of multifocal mesenteric DTF in a patient post-liver transplantation.
- To highlight the importance of thorough histopathological and immunohistochemical analysis in differentiating DTF.
- To provide insights into the pathological features and differential diagnosis of complex DTF cases.
Main Methods:
- Abdominal ultrasound identified a hypoechoic inter-intestinal mass.
- Abdominal computed tomography (CT) revealed a well-demarcated mesenteric soft tissue mass.
- Surgical intervention followed by histopathological and immunohistochemical examination confirmed mesenteric DTF (MDF).
Main Results:
- Post-liver transplantation surveillance led to the incidental diagnosis of multifocal DTF.
- Histopathology confirmed MDF with reactive mesenteric lymph node hyperplasia.
- Differential diagnoses including GIST and leiomyosarcoma were systematically excluded.
Conclusions:
- Comprehensive histopathological evaluation is pivotal for accurate DTF diagnosis, especially when distinguishing from GIST and sarcoma.
- This case underscores the importance of recognizing DTF's distinct pathological features in complex abdominal presentations.
- The report serves as a practical reference for managing challenging cases of mesenteric DTF.
