Spontaneous isolated mesenteric fibromatosis associated with small bowel obstruction

A 65-year-old female presented with history of sudden severe abdominal pain associated with nausea and vomiting. On physical examination, the patient had abdominal distension with the mid-abdomen tenderness. A computed tomography (CT) scan of the abdomen revealed the presence of internal hernias (Fig. 1). An exploratory laparotomy was performed which showed adherences between nodules of the small intestine's mesentery and the upper jejunum near the ligament of Treitz and a dilated remote bowel. Microscopic examination showed fascicles of spindle cells surrounded by fibrillar collagen with few mitotic figures (Fig. 2). Immunohistochemistry revealed the tumor cells to be negative for CD 117 and desmin, but positive for ss-catenin stains consistent with the diagnosis of mesenteric fibromatosis.