A Case of Giant Mesenteric Desmoid Fibromatosis (30 cm in Diameter) with Abscess Formation

Abstract

A 22-year-old man presented with abdominal distention and abdominal pain. He was referred to our hospital for further treatment, because a contrast-enhanced computed tomography revealed a large intra-abdominal tumor of mesenteric origin that showed a rapid growth tendency with intra-tumorous hemorrhage and abscess formation. C-reactive protein was markedly elevated, and he was in a poor general condition with coagulopathy and severe nutritional disorder. We identified the tumor origin to be the ileocecal mesentery and judged that the tumor could be removed by semi-urgent ileocecal resection. A tumor 30 cm in size was found in the ileocecal mesentery, with invasion into the cecum and appendix. Based on histopathological findings, a diagnosis of desmoid fibromatosis was made. In this study, we experienced a case of resection of a giant mesenteric desmoid tumor that showed a rapid growth tendency with intratumoral abscess formation. Giant mesenteric desmoid tumors can be complicated by abscess formation, resulting in poor general condition, and it is important to perform surgery safely after thorough imaging evaluation to avoid missing the time when surgical resection is possible.