Mesenchymal solid tumors of the omentum and mesentery: report of four cases

Attention is drawn to the solitary solid tumors originating in the intra-abdominal mesenteries and in the omentum. These are rare lesions, each associated with an insidious onset and with a laterally ballotable mass frequently representing the only expression of disorder clinically. Some mesenchymal lesions have long eluded the pathologist and the surgeon in the frustration of firmly categorizing the predominant cellular involvement. At times there is an area of "spill-over" or of mixed tumor elements within the same lesion. Occasionally the lesion type is defined eventually only by recurrence and/or a lethal outcome attributable to tumor spread, regardless of its original cellular features. The management of four patients, two with omental tumors (leiomyoblastoma) and two with tumors of mesenteric origin (one patient with fibromatosis and the other with leiomyosarcoma), is presented from the 15 year experience of a large hospital facility. The uncomplicated diagnostic investigations are stressed as well as the essentiality of wide surgical resection to fully elaborate all morphologic features and to thwart recurrent disease in the future.