Huge mesenteric fibromatosis presenting with intestinal perforation and acute diffuse peritonitis: a case report

Abstract

Mesenteric fibromatosis is a locally invasive myofibroblastic proliferation and rarely metastasize to other organs. Hollow organ perforation and acute diffuse peritonitis caused by mesenteric fibromatosis rarely occurred. Here we report a case of huge mesenteric fibromatosis who complained a paroxysmal epigastric pain, and CT scan showed a huge mass, pneumoperitoneum and ascites. An urgent laparotomy showed an intro-abdominal mass and perforation locating at the jejunum. Postoperative histology confirmed it to be mesenteric fibromatosis. With one-year follow-up, the patient had no recurrence. We wish to share our treating experience of this interesting case because it did not belong to a typical type but presenting with acute diffuse peritonitis, and total resection and R0 margin is a key to treat acute case. This atypical one has not been reported in the literature till now.

Solitary mesenteric fibromatosis in a male patient: clinical case report

“…These tumors present as insidious and asymptomatic masses that invade adjacent structures and are found incidentally during a physical examination [ 3 , 7 ]. According to their relation to adjacent organs, they can cause severe complications, such as intestinal obstruction, perforation, ischemia, hydronephrosis, fistula and even aortic rupture or infiltration of the hepatic portal tracts with obstructive jaundice [ 7 ].…”

“…The risk of mesenteric fibromatosis increases in association with previous surgery, trauma, estrogen and pregnancy. The onset age varies from 8 to 72 years with an average age of ⁓46.2 years [ 3 , 4 , 7 ]. It is more common in women than in men.…”

“…Desmoid tumors are classified as extra-abdominal and abdominal. They show variable localization, and the abdominal form is more frequent (57%) than the extra-abdominal form (43%) [ 3 , 7 ].…”

“…Abdominal desmoid tumors include several entities that show similar morphological features but different clinical presentations [ 1 , 8 , 9 ]. According to their localization, they can vary from an asymptomatic mass to a clinical presentation of intestinal obstruction and hydronephrosis, bleeding or perforation of a hollow organ [ 3 ].…”

Huge mesenteric desmoid-type fibromatosis with unusual presentation: A case report

“…We reported a rare case of diffuse peritonitis due to sporadic MDF with aggressive proliferation and consecutive intestinal perforation. Only a few similar cases have been reported in the literature [ [12] , [13] , [14] , [15] ] [ [12] , [13] , [14] , [15] ] [ [12] , [13] , [14] , [15] ].…”