title: Clinical and diagnostic problems of desmoid-type fibromatosis of the mesentery: case report and review of the literature.
abstract: BACKGROUND
  Desmoid-type fibromatosis (DTF) is a "locally aggressive, but not metastasizing" proliferation of soft tissues that is difficult to diagnose pre-operatively. Surgical en bloc resection of abdominal DTF can be difficult or an overtreatment. The diagnosis is therefore crucial for the decision making to minimize unnecessary morbidity.
  
  
  METHODS
  A 33-year old female patient with an incidental intra-operative diagnosis of a 20 cm mesenteric mass involving the duodenum, jejunum, ileum and right colon underwent extended resection for a DTF. A review of the literature, limited only to mesenteric localization of DTF, was performed for the diagnosis, treatment and outcome.
  
  
  RESULTS
  Twentyfive cases of DTF have been analyzed. Pre-operative diagnosis was suspected in 20% but 95,2% of all the patients underwent resection without pre-operative diagnosis. In two cases, intra-operative, frozen section diagnosis was unsuccessfully attempted. Complications were reported in 12%, recurrence in 4%, and mortality in 0% of the patients.
  
  
  CONCLUSIONS
  Pre-operative diagnosis of mesenteric DTF is challenging in most cases, but it can avoid unnecessary extended surgery. Efforts should be made to achieve a correct pre-operative diagnosis based on more reliable imaging and pathological features, to help in decision making.
authors.forename: Gaetano
authors.initials: G
authors.lastname: La Greca
authors.forename: Antonio
authors.initials: A
authors.lastname: Santangelo
authors.forename: Stefano
authors.initials: S
authors.lastname: Primo
authors.forename: Maria
authors.initials: M
authors.lastname: Sofia
authors.forename: Saverio
authors.initials: S
authors.lastname: Latteri
authors.forename: Domenico
authors.initials: D
authors.lastname: Russello
authors.forename: Gaetano
authors.initials: G
authors.lastname: Magro
mesh_terms: D000328:Adult; D005260:Female; D018222:Desmoid Tumors / Q000175:diagnosis*; D006801:Humans; D033162:Incidental Findings; D008643:Mesentery; D010534:Peritoneal Neoplasms / Q000175:diagnosis*