J Korean Soc Radiol.  2016 Apr;74(4):254-258. 10.3348/jksr.2016.74.4.254.

Mesenteric Fibromatosis Representing as a Colo-Colic Intussusception Mimicking the Ascending Colon Malignant Tumor with CT and 18F-Fluorodeoxyglucose Positron Emission Tomography/CT Findings: A Case Report

• Lee J
• Ha HI
• Kim MJ
• Hwang JH
• Lee K

• KMID: 2208783
• DOI: http://doi.org/10.3348/jksr.2016.74.4.254

Abstract

Mesenteric fibromatosis is a rare benign fibroblastic tumor; moreover, cases that occur in the mesocolon are even rarer. In some cases, mesenteric fibromatosis is difficult to differentiate from a malignant tumor that shows an infiltrative growth pattern or forms intussusception similar to lymphoma or adenocarcinoma. In this study, we reported a case of mesenteric fibromatosis represented as a colo-colic type intussusception adjacent to the ascending colon mimicking malignant tumors such as lymphoma or adenocarcinoma.

MeSH Terms

Adenocarcinoma
Colon, Ascending*
Electrons*
Fibroblasts
Fibroma*
Fibromatosis, Abdominal
Intussusception*
Lymphoma
Mesocolon

Figure

• 

  Fig. 1 A 47-year-old man presented with mesenteric fibromatosis at the ascending mesocolon forming colo-colic intussusception and mimicking malignant tumors. A. Colonoscopy shows a very large fungating mass with ulceration in the mid ascending colon. The biopsy needle cannot pass through the mass due to its hard-rubber like texture. B. The axial pre-contrast CT image reveals an approximately 7.2 cm well-defined mass at the right upper quadrant abdomen, which shows some high density area (*). C, D. The coronal reformatted contrast-enhanced CT image in the portal venous phase shows a lobulating mass forming colocolic intussusception (arrows). The mass shows a heterogeneous less enhancement feature and thin-enhancing inner layer suggesting that the mucosa is well-preserved (arrowheads). There is no lymph node enlargement or pericolic fat infiltration. E. Axial 18F-FDG PET/CT image shows an increased FDG-uptake (SUV max = 5.8) around the mid ascending colon (arrow) without evidence of metastasis. F. Gross pathological cut section shows a whitish tumor without necrosis or hemorrhage. G. The microscopic exam (hematoxylin and eosin stain, × 100) of the mass shows dense bundles of short spindle cells (arrows) and collagen fibers. H. In immunohistochemistry, the stain is positive for beta catenin (× 100) and negative for C-kit (× 100) and CD34 (× 100), which is very helpful in distinguishing mesenteric fibromatosis from other similar lesions. FDG = fluorodeoxyglucose, PET = positron emission tomography, SUV max = maximum standardized uptake value

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