Giant Mesenteric Fibromatosis Presenting as Small Bowel Obstruction

Abstract

Mesenteric fibromatosis is a proliferative fibroblastic neoplasia of the small intestine mesentery that may occur as a unique or multiple formation. Mesenteric fibromatosis is a rare, locally aggressive neoplasm and may present with abdominal discomfort, abdominal pain, weight loss, or symptoms of ureteral obstruction, mesenteric ischemia, or intestinal obstruction. It is of the utmost importance to distinguish mesenteric fibromatosis from gastrointestinal stromal tumors. Histopathology accurately differentiates between these two distinct entities. The preferred treatment is local surgical excision with a margin of uninvolved tissue. The involvement of important structures like the superior mesenteric artery and the superior mesenteric vein may pose a challenge during resection, but these tumors can be excised and the vessels repaired primarily.

Rare acute abdominal condition caused by mesenteric fibromatosis perforation

“…Severe complications, like intestinal obstruction, ischemia and perforation, hydronephrosis, ureteric fistula, and even aortic rupture, may result from MF infiltration into the adjacent organs. [13,14] In this case, a consecutive perforation from the ileum to the bottom of tumor was noted during the laparotomy. The ileum was perforated due to ischemia, which resulted from compression by the tumor, but not due to the direct infiltration by the tumor since no tumor cells were found in the ileal wall.…”

Intestinal obstruction caused by desmoid tumours: a review of the literature

“…6 All of the patients who presented with obstruction underwent oncologic resections of the involved intestinal segments with no reported recurrences. 3,6,8,9,[11][12][13] Complete resection of the tumour with negative microscopic margins is the standard surgical goal but is often constrained by anatomic boundaries. 10 One recent review of multimodal therapy for desmoid tumours in all anatomic locations showed that surgery supplemented with radiotherapy had reduced recurrence rates for patients with both positive and negative surgical margins.…”

“…PZ and JR edited the manuscript. PG was the Holubar et al 13 2006 52M Abdominal pain Laparotomy with en bloc resection of the terminal ileum and superior mesenteric artery and vein 22 cm mass at terminal ileum þBeta-catenin primary surgeon who spearheaded the submission of the manuscript.…”

Surgical treatment of giant mesenteric fibromatosis presenting as a gastrointestinal stromal tumor: a case report

“…In fact, the biology of intra-abdominal desmoid may be characterized by initial rapid growth, followed by stability or even regression. However, mesenteric desmoid, by virtue of its relationship to vital structures and its ability to infiltrate adjacent organs, may cause important complications, including intestinal obstruction, ischemia and perforation, hydronephrosis, and even aortic rupture [ 7 , 8 ]. Despite these complications, the overall ten-year-survival for patients with intra-abdominal desmoids can be as high as 60 to 70% [ 9 ].…”