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Mesenteric Fibromyoma Mimicking a Colon Tumor: A Diagnostic Dilemma

Received: 16 September 2014     Accepted: 29 September 2014     Published: 16 December 2014
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Abstract

Introduction: Solid primary tumors of mesenteric origin are quite rare among the intraabdominal soft tissue tumors. The most frequent tumors are Gastrointestinal Stromal Tumors (GIST) and smooth muscle tumors. GISTs as the largest group of these tumors are usually seen in the wall of gastrointestinal tract and 25% of them are malignant. They usually occur in adults and there is no sexual predominance. We present a huge intra-abdominal myoma clinically mimicking GIST. Case Report: A 49-years old male was referred to our deparment because of a growing mass and pain in the right lower quadrant. Physical examination revealed a huge mass with 10 cm in diameter in the right lower quadrant. Computed tomography (CT) revealed a mass with 17 cm in diameter which originated from caecum and extented from umblicus to urinary bladder and right colon. The mass was resected en-bloc with right hemicolectomy. The final diagnosis is ‘’Fibromyoma of the mesentery’’. Discussion: They usually arise de novo and are seen in adults. Myofibroma can occur as a solitary form or it can be seen as multiple lesions like generalized form which is described as myofibromatozis. Myofibromas are characteristically circumscribed masses with a nodular or multinodular growth pattern and they usually show a biphasic growth pattern . The behaviour of mesenteric smooth muscle tumours is unpredictable. Because they arise large diameters and they can cause different clinical symptoms like obstruction and abdominal pain. The treatment of mesenteric fibromyoma is complete resection. Large intraabdominal solid masses pose a diagnostic challenge either grossly or microscopically. Histopathologically, huge benign fibromyomas should be kept in mind of differantial diagnosis of GİSTs.

Published in Journal of Surgery (Volume 2, Issue 6)
DOI 10.11648/j.js.20140206.12
Page(s) 88-92
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2014. Published by Science Publishing Group

Keywords

Colectomy, Gastrointestinal Stromal Tumors, Myofibroma, Smooth Muscle Actin

References
[1] Kalogiannidis I , Stavrakis T, Amplianitis I, Grammenou S, Mavromatidis G, Rousso D. Primary Mesenteric Smooth Muscle Tumor: An Entity with Unpredictable Biologic Behavior. Case Rep Obstet Gynecol. 2013; 2013: 483689.
[2] Kim MJ, Lee SH, Youk EG, Lee S, Choi JH, Cho KJ. Solitary myofibroma of the sigmoid colon: case report and review of the literature. Diagn Pathol. 2013; 8: 90.
[3] Colombo P, Rahal D, Grizzi F, Quagliuolo V, Roncalli M. Localized intra-abdominal fibromatosis of the small bowel mimicking a gastrointestinal stromal tumor: a case report. World J Gastroenterol. 2005; 11(33): 5226-8.
[4] Montagliani L, Duverger V. Desmoid Tumors. Journal de Chirurgie. 2008; 67(11): 20-26.
[5] Singla SL, Rattan KN, Kaushik N. Mesenteric Leiomyoma in infancy. Indian Journal of Pediatrics. 2000; 67(11): 857-858.
[6] Estes WL. X. Myofibroma of the Large Intestine. Ann Surg. 1906; 44(2): 249–260.
[7] Chung EB, Enzinger FM. Infantile myofibromatosis. Cancer. 1981; 8: 1807–1818.
[8] Stout AP. Juvenile fibromatoses. Cancer. 1954; 8: 953–978.
[9] Fletcher CDM, Unni KK, Mertens F. World health organization classifiction of tumors. Pathology and genetics of tumors of soft tissue and bone. Lyon: IARC Press; 2002.
[10] Yannopoulos K, Stout AP. Primary solid tumors of the mesentery. Cancer. 1963; 16: 914-927.
[11] Fasih N, Shanbhogue AKP, Macdonald DB, et al. Leiomyomas beyond the uterus: unusual locations, rare manifestations. Radiographics. 2008; 28(7): 1931-1948.
[12] Tietze L, Günther K, Hörbe A, et al. Benign metastasizing leiomyoma: a cytogenetically balanced but clonal disease. Human Pathology. 2000; 31(1): 126-128.
[13] Wu W, Chen J, Cao X, Yang M, Zhu J, Zhao G. Solitary infantile myofibromatosis in the bones of the upper extremities: Two rare cases and a review of the literature. Oncology Letter. 2013; 6 (5): 1406-1408.
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  • APA Style

    Safak Ozturk, Ozhan Cetindag, Mutlu Unver, Melek Uncel, Burcin Kibar Ozturk, et al. (2014). Mesenteric Fibromyoma Mimicking a Colon Tumor: A Diagnostic Dilemma. Journal of Surgery, 2(6), 88-92. https://doi.org/10.11648/j.js.20140206.12

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    ACS Style

    Safak Ozturk; Ozhan Cetindag; Mutlu Unver; Melek Uncel; Burcin Kibar Ozturk, et al. Mesenteric Fibromyoma Mimicking a Colon Tumor: A Diagnostic Dilemma. J. Surg. 2014, 2(6), 88-92. doi: 10.11648/j.js.20140206.12

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    AMA Style

    Safak Ozturk, Ozhan Cetindag, Mutlu Unver, Melek Uncel, Burcin Kibar Ozturk, et al. Mesenteric Fibromyoma Mimicking a Colon Tumor: A Diagnostic Dilemma. J Surg. 2014;2(6):88-92. doi: 10.11648/j.js.20140206.12

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  • @article{10.11648/j.js.20140206.12,
      author = {Safak Ozturk and Ozhan Cetindag and Mutlu Unver and Melek Uncel and Burcin Kibar Ozturk and Eyup Kebabci and Umit Bayol},
      title = {Mesenteric Fibromyoma Mimicking a Colon Tumor: A Diagnostic Dilemma},
      journal = {Journal of Surgery},
      volume = {2},
      number = {6},
      pages = {88-92},
      doi = {10.11648/j.js.20140206.12},
      url = {https://doi.org/10.11648/j.js.20140206.12},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20140206.12},
      abstract = {Introduction: Solid primary tumors of mesenteric origin are quite rare among the intraabdominal soft tissue tumors. The most frequent tumors are Gastrointestinal Stromal Tumors (GIST) and smooth muscle tumors. GISTs as the largest group of these tumors are usually seen in the wall of gastrointestinal tract and 25% of them are malignant. They usually occur in adults and there is no sexual predominance. We present a huge intra-abdominal myoma clinically mimicking GIST. Case Report: A 49-years old male was referred to our deparment because of a growing mass and pain in the right lower quadrant. Physical examination revealed a huge mass with 10 cm in diameter in the right lower quadrant. Computed tomography (CT) revealed a mass with 17 cm in diameter which originated from caecum and extented from umblicus to urinary bladder and right colon. The mass was resected en-bloc with right hemicolectomy. The final diagnosis is ‘’Fibromyoma of the mesentery’’. Discussion: They usually arise de novo and are seen in adults. Myofibroma can occur as a solitary form or it can be seen as multiple lesions like generalized form which is described as myofibromatozis. Myofibromas are characteristically circumscribed masses with a nodular or multinodular growth pattern and they usually show a biphasic growth pattern . The behaviour of mesenteric smooth muscle tumours is unpredictable. Because they arise large diameters and they can cause different clinical symptoms like obstruction and abdominal pain. The treatment of mesenteric fibromyoma is complete resection. Large intraabdominal solid masses pose a diagnostic challenge either grossly or microscopically. Histopathologically, huge benign fibromyomas should be kept in mind of differantial diagnosis of GİSTs.},
     year = {2014}
    }
    

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  • TY  - JOUR
    T1  - Mesenteric Fibromyoma Mimicking a Colon Tumor: A Diagnostic Dilemma
    AU  - Safak Ozturk
    AU  - Ozhan Cetindag
    AU  - Mutlu Unver
    AU  - Melek Uncel
    AU  - Burcin Kibar Ozturk
    AU  - Eyup Kebabci
    AU  - Umit Bayol
    Y1  - 2014/12/16
    PY  - 2014
    N1  - https://doi.org/10.11648/j.js.20140206.12
    DO  - 10.11648/j.js.20140206.12
    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
    SP  - 88
    EP  - 92
    PB  - Science Publishing Group
    SN  - 2330-0930
    UR  - https://doi.org/10.11648/j.js.20140206.12
    AB  - Introduction: Solid primary tumors of mesenteric origin are quite rare among the intraabdominal soft tissue tumors. The most frequent tumors are Gastrointestinal Stromal Tumors (GIST) and smooth muscle tumors. GISTs as the largest group of these tumors are usually seen in the wall of gastrointestinal tract and 25% of them are malignant. They usually occur in adults and there is no sexual predominance. We present a huge intra-abdominal myoma clinically mimicking GIST. Case Report: A 49-years old male was referred to our deparment because of a growing mass and pain in the right lower quadrant. Physical examination revealed a huge mass with 10 cm in diameter in the right lower quadrant. Computed tomography (CT) revealed a mass with 17 cm in diameter which originated from caecum and extented from umblicus to urinary bladder and right colon. The mass was resected en-bloc with right hemicolectomy. The final diagnosis is ‘’Fibromyoma of the mesentery’’. Discussion: They usually arise de novo and are seen in adults. Myofibroma can occur as a solitary form or it can be seen as multiple lesions like generalized form which is described as myofibromatozis. Myofibromas are characteristically circumscribed masses with a nodular or multinodular growth pattern and they usually show a biphasic growth pattern . The behaviour of mesenteric smooth muscle tumours is unpredictable. Because they arise large diameters and they can cause different clinical symptoms like obstruction and abdominal pain. The treatment of mesenteric fibromyoma is complete resection. Large intraabdominal solid masses pose a diagnostic challenge either grossly or microscopically. Histopathologically, huge benign fibromyomas should be kept in mind of differantial diagnosis of GİSTs.
    VL  - 2
    IS  - 6
    ER  - 

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Author Information
  • Tepecik Teaching and Research Hospital, Department of General Surgery, Izmir, Turkey

  • Tepecik Teaching and Research Hospital, Department of General Surgery, Izmir, Turkey

  • Tepecik Teaching and Research Hospital, Department of General Surgery, Izmir, Turkey

  • Tepecik Teaching and Research Hospital, Department of Pathology, Izmir, Turkey

  • Ege University Faculty of Medicine, Department of Radiology, Izmir, Turkey

  • Tepecik Teaching and Research Hospital, Department of General Surgery, Izmir, Turkey

  • Tepecik Teaching and Research Hospital, Department of Pathology, Izmir, Turkey

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