Misdiagnosis of ligamentoid fibromatosis of the small mesenteric: A case report

Abstract

Background: Ligamentoid fibromatosis is a rare borderline tumor that occurs in the muscles, fascia, and aponeurosis. It is a kind of soft tissue tumor of fibrous origin, also known as invasive fibromatosis, desmoid fibroma, neurofibromatosis, etc. The tumor is between benign and malignant tumors and rarely has distant metastasis. Its characteristics are mainly local invasion, destruction and growth and easy recurrence. The World Health Organization defines it as a fibroblast cloning value-added lesion originating from deep soft tissue, which causes local invasion and growth leading to tissue reconstruction, extrusion and destruction of important structures and organs. The incidence rate accounts for 0.03% of all tumors and less than 3% of all soft tissue tumors. Definite diagnosis mainly depends on postoperative pathology. Surgical resection is still the main way to treat the disease, and a variety of nonsurgical treatment methods are auxiliary. Combined treatment can effectively reduce the risk of postoperative recurrence.

Case summary: The patient is a 57-year-old female. One week ago, she accidentally found a mass in the left upper abdomen while lying flat. There was no abdominal pain and abdominal distention, no fever, no black stool and blood in the stool and no nausea and vomiting. She had a 10-year history of glaucoma on the left side, underwent hysterectomy for uterine fibroids 5 years ago, had no hypertension, heart disease, diabetes, hepatitis or tuberculosis, had no history of smoking and had been drinking for 20 years.

Conclusion: Accurate preoperative diagnosis is difficult, surgical resection is the main treatment, and a variety of nonsurgical treatment methods are auxiliary. Combined treatment can effectively reduce the risk of postoperative recurrence. The prognosis is still good, and the risk of recurrence of secondary surgery is greatly increased.

Keywords: Borderline tumor; Case report; Combined treatment; Ligamentoid fibromatosis; Pathology; Small mesenteric; Surgery.

Figure 1

Hematoxylin and eosin staining and immunohistochemistry (× 40). A: Hematoxylin and eosin staining of tumor; B: Immunohistochemistry showed positive Ki-67; C: Immunohistochemistry showed positive β-catenin.

Figure 2

Specimen of the tumor. A: A comprehensive view of the gross specimen of the tumor; B: Specimen view in section.

Figure 3

Computed tomography. A: Abdominal computed tomography (CT) of the patient; B: Abdominal CT arterial phase; C: Abdominal CT venous phase; D: Abdominal CT delay.