Mesenteric Desmoid Tumour in an Octogenarian: A Rare Case from Rural Eastern Nigeria

Introduction: Mesenteric desmoid tumours are rare, locally aggressive fibroblastic neoplasms comprising just 0.03% of all tumours. They typically affect younger adults and may be associated with familial adenomatous polyposis (FAP), trauma, or prior abdominal surgery. Diagnosis is challenging due to imaging similarities with other intra-abdominal masses, and treatment must be tailored to tumour behaviour and patient factors. Case Report: We report the case of an 85-year-old woman from rural Nigeria presenting with a six-month history of abdominal discomfort, early satiety, and weight loss. Examination revealed a firm, mobile abdominal mass. CT imaging showed a large mesenteric mass, but the patient had no history of FAP, trauma, or surgery. Comorbid hypertension and ECG findings of first-degree heart block elevated surgical risk. In view of limited access to advanced therapies and her frailty, a conservative management plan was adopted. Discussion: This case highlights the importance of considering desmoid tumours in elderly patients and adapting management to local resources and comorbid conditions. While surgery remains a mainstay of treatment, conservative strategies may be preferable in high-risk or resource-limited settings. Broader access to emerging therapies is needed to improve outcomes in underserved populations.