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Case Reports
. 2020 Sep;9(9):5674-5678.
doi: 10.21037/tcr-19-1151.

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

Yingying Xu #  1 , Zongkui Duan #  2 , Wenqing Hu #  3 , Kaixuan Zhu  2 , Jun You  4 , Masanobu Abe  5 , Ping Chen  2 , Qinyuan Zhang  6 , Liang Zong  2   3   7
Affiliations
Case Reports

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

Yingying Xu et al. Transl Cancer Res. 2020 Sep.

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.

Keywords: APC gene; Mesenteric fibromatosis; acute diffuse peritonitis; beta-catenin; case report; desmoid; hollow organ perforation; hormone receptors.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/tcr-19-1151). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Abdominal computed tomography (CT) scan showed a huge mass measuring approximately 17 cm × 10 cm almost occupying the entire left abdominal cavity and the intestine was pressed (arrow).
Figure 2
Figure 2
A well-circumscribed lesion with smooth external surface measuring about 17 cm × 10 cm × 10 cm was identified at the mesentery of the jejunum.
Figure 3
Figure 3
The tumor and the nearby jejunum both had perforations (arrow head), and then the gastrointestinal (GI) contents effused via the hole (arrow) causing acute diffuse peritonitis.
Figure 4
Figure 4
Hematoxylin-eosin (HE) staining shows homogeneous proliferation of bundles of spindle-like tumor cells associated with collagen deposition (magnification, 10×10).
Figure 5
Figure 5
Case report timeline.
See this image and copyright information in PMC

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