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.