Perforating sclerosing mesenteritis of the colon mimicking a tumor: autopsy case report and mini-review

Abstract

Aim and subject. Sclerosing mesenteritis is a rare non-tumoral disease that usually affects the small intestine.Several etiological hypotheses have been proposed (external or surgical trauma, autoimmunity, neoplasia). Clinical case description and main results. We describe the autopsy case of a 66-year-old woman who presented to hospital unconscious with a palpable abdominal mass. The patient underwent abdominal CT, which revealed a mass involving the transverse colon and mesocolon with non-pathognomonic 
features, but with a strong suspicion of neoplasia. However, the patient died quickly, before a biopsy could be performed. The only prominent finding at autopsy was a transverse colonic wall mass associated with colic perforation and mucosal hyperplasia. Histology 
revealed sclerosing mesenteritis after a thorough microscopic and immunohistochemical investigation of possible differential diagnoses. Conclusions. There are three types of sclerosing mesenteritis, depending on the fibrous component, and the case described is an example of retractile mesenteritis (preponderant fibrosis). A mini-review of the Pubmed database shows that the different ways of referring to this disease make it difficult to search, but a total of 213 cases appear to be published so far. Overall, the location, clinical presentation and macroscopic findings of our case represent a true rarity.