Intra-abdominal Mesenteric fibromatosis : CT findings, patterns and differential diagnosis. Our experience.

Congress:

ECR 2013

Poster Number:

C-1120

Type:

Educational Exhibit

Keywords:

Neoplasia, Cancer, Diagnostic procedure, CT, Oncology, Abdomen

Authors:

R. Carbone¹, F. R. Setola², C. PICONE³, O. Fabozzi³, C. Rossi ⁴, V. Granata⁵, M. L. Barretta⁶, E. de Lutio di Castelguidone⁴, A. Gallipoli D'Errico³; ¹Napoli (NA)/IT, ²Naples, I/IT, ³Naples (NA)/IT, ⁴Naples/IT, ⁵Vitulazio (CE)/IT, ⁶Caserta (CE)/IT

DOI:

10.1594/ecr2013/C-1120

DOI-Link:

https://dx.doi.org/10.1594/ecr2013/C-1120

Fig. 1: Fig.1 – Classification of fibromatosis

Fig. 2: Fig.2 (a-c): ‘nodular’ fibromatosis : it presents like a nodular mass, with...

Fig. 3: Fig. 3-a . Ileal mass with exophytic growth, colliquative necrotic center and...

Fig. 4: Fig. 4 : Benign diffuse fibromatosis: a voluminous mass origining from the root...

Learning objectives

Analysis of CT findings characteristic for each of the three growth pattern of intra-abdominal mesenteric fibromatosis.

Background

Fibromatosis, according to the classification of WHO (2002), is a benign fibroblastic tumor which comprises a group of lesions that differ in the site of onset (see Fig.1) and for their clinical behavior. Feature of this spectrum of disease is the discrepancy, in particular, between their benign histo-morphological appearance and their locally aggressive behavior, with tendency to microscopic infiltration of the surrounding tissues and local recurrence , even in the absence of distant metastases. Mesenteric fibromatosis is the most frequent form of intra-abdominal fibromatosis (desmoid...

Imaging findings OR Procedure details

Radiological aspects, that often characterize fibromatoses, are not discriminative compared to more frequent conditions allocated in the mesentery, such as mesenteryal cysts, adenocarcinomas, lymphomas, GISTs, desmoplastic reaction from carcinoids or metastases. However, their recognition is essential for proper management. US and CT are the methods that best provide a diagnostic orientation, identifying the lesion, mesenteric origin, size, low-grade malignancy and the absence of distant metastases. The CT iconographic aspect of fibromatosis is directly related to the histology of the lesion, and in particular to the...

Conclusion

It’ s fundamental the knowledge of typical CT-imaging pattern of fibromatosis , especially because it enters in differential diagnosis with other common lesions of the mesenterial fat. In conclusion, in our experience, CT-features can suggest the diagnosis, the definitive response is confirmed by histology and immunohistochemistry.

References

1. Shinagare AB, Ramaiya NHet al. A to Z of desmoid tumors. AJR Am J Roentgenol. 2011 Dec;197(6) 2. Kempson RL, Fletcher CD, Evans HL, Hendrickson MR, Sibley RK. Tumors of the soft tissues. Washington, DC: Armed Forces Institute of Pathology, 1998. 3. Stanford University School of Medicine. Mesenteric fibromatosis — surgical pathology criteria. Available from URL: http:// surgpathcriteria.stanford.edu/. Assessed Jul 2010. 4. Lotfi AM, Dozois RR et al. Mesenteric fibromatosis complicating familial adenomatous polyposis: predisposing factors and results of treatment. Int J Colorectal Dis...