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Mesenteric fibromatosis as an irreducible inguinal hernia

Samantha Jiselle Go Siahetiong1, Mark Augustine S Onglao2, Sofia Isabel Tamesa Manlubatan2

  • 1Department of Surgery, University of the Philippines, Philippine General Hospital, Manila, Philippines sgsiahetiong1@alum.up.edu.ph.

BMJ Case Reports
|January 19, 2025
PubMed

Insights

A rare case of desmoid-type fibromatosis presented as an irreducible inguinal hernia in a hypertensive male. Surgical intervention revealed the mass was not a hernia but fibromatosis, requiring ileal resection and mesh repair.

Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Abdominal Imaging

Background:

  • Inguinal masses can present diagnostic challenges, sometimes mimicking hernias.
  • Desmoid-type fibromatosis is a rare mesenchymal tumor with potential for abdominal wall involvement.

Purpose of the Study:

  • To report a unique case of desmoid-type fibromatosis mimicking an irreducible inguinal hernia.
  • To highlight the importance of histopathological confirmation in complex abdominal masses.

Main Methods:

  • Case presentation of a 60-year-old male with a 3-year history of an irreducible left inguinal mass.
  • Diagnostic workup included clinical examination and computed tomography (CT) scan.
  • Surgical management involved exploratory laparotomy, ileal resection and anastomosis, and mesh hernioplasty.

Main Results:

  • CT scan revealed an anterior abdominal wall defect at the left inguinal region.
  • Histopathology and immunohistochemistry confirmed the mass as desmoid-type fibromatosis, not an incarcerated hernia.
  • The patient underwent surgical resection and repair.

Conclusions:

  • Desmoid-type fibromatosis can present as an irreducible inguinal mass, posing a diagnostic dilemma.
  • Multimodality imaging and definitive histopathological analysis are crucial for accurate diagnosis and appropriate management of such cases.

Keywords:
Gastrointestinal surgeryGastrointestinal systemGeneral surgeryStomach and duodenum

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