Idiopathic sclerosing mesenteritis. Case report and differential diagnosisof a rare disease

We report the case of a 78-year-old woman with the endoscopic tentative dia gnosis of a malignant tumor of the colon ascendens (biopsy without malignan cy) that was removed by right hemicolectomy. Extensive mesenteric infiltrat ion and colonic obstruction seemed to confirm this diagnosis. Surprisingly histology revealed invasion by sclerosing mesenteritis. The differential di agnoses include inflammatory pseudotumor, tumor-like fibromatosis at trauma tized sites, idiopathic retroperitoneal fibromatosis, sclerosing malignant lymphoma, liposarcoma and drug-induced sclerosing mesenteritis, as well as mesenteric infiltration and metastases. Though preoperative diagnosis is no t possible in most cases, the intraoperative macroscopic appearance and the histopathologic picture are conclusive.