• Kawari Sowbhagyalaxmi
  • Rajat Choudhari Kasturba Medical College, Mangalore
  • Rahul Bhat
  • Shivananda Prabhu
  • Poornachandra Thejeswi
Keywords: Desmoid tumors, mesenteric fibromatosis, beta catenin, appendicular abscess


Desmoids are rare tumors of fibroblast origin and comprise about 0.03% of all neoplasms. These are benign tumors arising from soft tissues and classified based on location - abdominal wall, intra and extra abdominal. In the abdomen, mesentery is the commonest location, and they are termed as mesenteric fibromatosis (MF). A 38-year-old male presented with fever, abdominal pain with tenderness and rebound tenderness localised to the right iliac fossa and was diagnosed as appendicular abscess. He was initially treated with percutaneous drainage and antibiotics and underwent exploratory laparotomy which revealed a mass at the ileocecal junction. Histopathology showed spindle cells and immunohistochemistry confirmed a diagnosis of mesenteric fibromatosis. These are slow growing tumors and present with nonspecific symptoms such as pain abdomen, constipation, appetite and weight loss, fever, abdominal distension and ureteral obstruction. Diagnosis is confirmed only after immunohistochemistry. Multimodal approach for treatment is followed with surgery being the primary treatment and Radiation therapy (RT), chemotherapy, anti- estrogenic therapy, NSAIDs and tyrosine kinase inhibitors (TKIs) used adjunctively. Mesenteric fibromatosis is a rare condition with varied presentation and if diagnosed early, has a good prognosis with few complications due to variety of available treatment options.


[1] K. Hayashi et al., “A mesenteric desmoid tumor with rapid progression,” Intern. Med., vol. 56, no. 5, pp. 505–508, 2017, doi: 10.2169/internalmedicine.56.7320.
[2] T. Desmoid Tumor Working Group et al., “The management of desmoid tumours: A joint global consensus-based guideline approach for adult and paediatric patients The Desmoid Tumor Working Group 1,” Eur. J. Cancer, vol. 127, pp. 96–107, 2020, doi: 10.1016/j.ejca.2019.11.013.
[3] K. Huang, H. Stuart, K. Lyapichev, A. E. Rosenberg, and A. S. Livingstone, “Mesenteric desmoid tumour presenting with recurrent abdominal abscess and duodenal fistula: A case report and review of literature,” Int. J. Surg. Case Rep., vol. 37, pp. 119–123, Jan. 2017, doi: 10.1016/j.ijscr.2017.06.007.
[4] M. D, “Mesenteric Fibromatosis (Desmoid Tumour) - A Rare Case Report,” J. Clin. DIAGNOSTIC Res., vol. 8, no. 11, p. ND01, 2014, doi: 10.7860/jcdr/2014/8520.5098.
[5] H. Ji et al., “A giant mesenteric fibromatosis involving the muscular layer of the colon wall,” Medicine (Baltimore)., vol. 98, no. 1, p. e14015, Jan. 2019, doi: 10.1097/MD.0000000000014015.
[6] P. Li, Z. Zhang, S. Qin, and J. Li, “The diagnosis of mesenteric fibromatosis: A 90-month five patients case report,” J. Cancer Res. Ther., vol. 12, no. 4, p. 1318, Oct. 2016, doi: 10.4103/0973-1482.199539.
[7] P. Chaudhary, “Mesenteric fibromatosis,” International Journal of Colorectal Disease, vol. 29, no. 12. Springer Verlag, pp. 1445–1451, Aug. 21, 2014, doi: 10.1007/s00384-014-1995-7.
[8] M. Abate and A. Pigazzi, “Mesenteric fibromatosis in a patient with a history of neuroblastoma: a case report,” J. Surg. Case Reports, vol. 2018, no. 9, pp. 1–3, Sep. 2018, doi: 10.1093/jscr/rjy209.
[9] P. K. Koh et al., “Mesenteric desmoid tumors in singapore familial adenomatous polyposis patients: Clinical course and genetic profile in a predominantly chinese population,” Diseases of the Colon and Rectum, vol. 50, no. 1. Springer New York, pp. 75–82, Jan. 01, 2007, doi: 10.1007/s10350-006-0759-z.
[10] M. Wronski, B. Ziarkiewicz-Wroblewska, M. Slodkowski, W. Cebulski, B. Gornicka, and I. W. Krasnodebski, “Mesenteric fibromatosis with intestinal involvement mimicking a gastrointestinal stromal tumour,” Radiol. Oncol., vol. 45, no. 1, pp. 59–63, Mar. 2011, doi: 10.2478/v10019-010-0051-7.
[11] C. H. Tan, U. Pua, K. H. Liau, and H. Y. Lee, “Mesenteric desmoid tumour masquerading as a fat-containing cystic mass,” Br. J. Radiol., vol. 83, no. 994, p. e200, Oct. 2010, doi: 10.1259/bjr/68468861.
[12] J. Church et al., “Staging Intra-Abdominal Desmoid Tumors in Familial Adenomatous Polyposis: A Search for a Uniform Approach to a Troubling Disease,” Dis. Colon Rectum, vol. 48, no. 8, pp. 1528–1534, Aug. 2005, doi: 10.1007/s10350-005-0018-8.
[13] G. H. Sakorafas, C. Nissotakis, and G. Peros, “Abdominal desmoid tumors,” Surgical Oncology, vol. 16, no. 2. Elsevier, pp. 131–142, Aug. 01, 2007, doi: 10.1016/j.suronc.2007.07.009.
[14] S. Tolan, J. H. Shanks, M. Y. Loh, B. Taylor, and J. P. Wylie, “Fibromatosis: Benign by Name but not Necessarily by Nature,” Clin. Oncol., vol. 19, no. 5, pp. 319–326, Jun. 2007, doi: 10.1016/j.clon.2007.03.002.
[15] A. Hansmann, C. Adolph, T. Vogel, A. Unger, and G. Moeslein, “High-Dose Tamoxifen and Sulindac as First-Line Treatment for Desmoid Tumors,” Cancer, vol. 100, no. 3, pp. 612–620, Feb. 2004, doi: 10.1002/cncr.11937.
How to Cite
K. Sowbhagyalaxmi, R. Choudhari, R. Bhat, S. Prabhu, and P. Thejeswi, “UNUSUAL CASE OF MESENTERIC FIBROMATOSIS MASQUERADING AS AN APPENDICULAR ABSCESS”, JSS, vol. 9, no. 1, May 2022.