UNUSUAL CASE OF MESENTERIC FIBROMATOSIS MASQUERADING AS AN APPENDICULAR ABSCESS

Kawari Sowbhagyalaxmi; Rajat Choudhari; Rahul Bhat; Shivananda Prabhu; Poornachandra Thejeswi

doi:10.33695/jss.v9i1.564

Kawari Sowbhagyalaxmi
Rajat Choudhari Kasturba Medical College, Mangalore
Rahul Bhat
Shivananda Prabhu
Poornachandra Thejeswi

DOI: https://doi.org/10.33695/jss.v9i1.564

Keywords: Desmoid tumors, mesenteric fibromatosis, beta catenin, appendicular abscess

Abstract

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.

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