Unravelling the Mystery of Mesenteric Fibromatosis: A Rare Case Report

Abstract

Mesenteric Fibromatosis (MF) is a proliferative fibroblastic lesion of the small intestinal mesentery. It constitutes 8% of all desmoid tumours, which represent 0.03% of all neoplasms. Although histologically benign, MF can invade locally and recur after excision. It occurs sporadically or in association with Familial Adenomatous Polyposis (FAP) mutation as a component of Gardner’s syndrome. The presenting features of MF include an asymptomatic abdominal mass, abdominal discomfort or pain, bowel or ureteral obstruction, intestinal perforation, fistula, or functional impairment of ileoanal anastomosis following colectomy in FAP cases. We report the case of a 29-year-old male who presented with a swelling on the right side of the umbilicus for six months, associated with dull aching pain for two months. Fine Needle Aspiration Cytology (FNAC), Ultrasonography (USG), and Contrast Enhanced Computed Tomography (CECT) findings were inconclusive. Exploratory laparotomy revealed a mass measuring approximately 6×5×4 cm in the ileal mesentery, which was excised along with 20 cm of ileum. Histopathology confirmed the diagnosis of MF. Considering the rarity of this tumour and the diagnostic and therapeutic challenges associated with it, we present this case to add to the existing literature.

Keywords

• desmoid
• familial adenomatous polyposis
• neoplasms