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Small bowel desmoid tumor

Case contributed by Michael P Hartung
Diagnosis certain

Presentation

Abdominal pain.

Patient Data

Gender: Male
ct

Right mid abdominal soft tissue mass narrowing a loop of ileum. Abnormal long segment of small bowel leading into the mass with "mural stratification" in the form of mucosal hyperemia, submucosal edema, and serosal enhancement. Mild mesenteric edema, few borderline mesenteric lymph nodes, and small ascites. Distal small bowel decompressed. 

Case Discussion

The patient underwent surgical resection of this mass which was found to be "desmoid-type fibromatosis" with negative lymph nodes. The mass was located within the lumen of the small intestine and described as a tan-white, firm submucosal mass. The upstream small bowel was noted to thickened and hyperemic at the time of surgery without a definite cause (and thus presumably reactive). 

The differential diagnosis for this mass was GIST, carcinoid, lymphoma, or adenocarcinoma. Small bowel desmoid is an uncommon and unexpected (but positive as it is benign) outcome for this case. 

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