Case Report
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World J Gastroenterol. Feb 7, 2014; 20(5): 1361-1364
Published online Feb 7, 2014. doi: 10.3748/wjg.v20.i5.1361
Nodular fasciitis in the mesentery, a differential diagnosis of peritoneal carcinomatosis
Mai Shiga, Ken Okamoto, Manabu Matsumoto, Hiromichi Maeda, Ken Dabanaka, Tsutomu Namikawa, Sunao Uemura, Masaya Munekage, Michiya Kobayashi, Kazuhiro Hanazaki
Mai Shiga, Ken Okamoto, Hiromichi Maeda, Ken Dabanaka, Tsutomu Namikawa, Sunao Uemura, Masaya Munekage, Michiya Kobayashi, Kazuhiro Hanazaki, Department of Surgery, Kochi Medical School, Kochi 783-8505, Japan
Ken Okamoto, Hiromichi Maeda, Michiya Kobayashi, Cancer Treatment Center, Kochi Medical School, Kochi 783-8505, Japan
Manabu Matsumoto, Laboratory of Diagnostic Pathology, Kochi Medical School Hospital, Kochi 783-8505, Japan
Author contributions: Shiga M, Okamoto K, Maeda H, Namikawa T, Uemura S, Munekage M and Kobayashi M designed the report; Shiga M, Okamoto K, Maeda H and Dabanaka K were attending doctors for the patients and performed surgical operation; Matsumoto M performed pathological examinations; Shiga M, Maeda H and Hanazaki K wrote paper.
Correspondence to: Hiromichi Maeda, MD, PhD, Department of Surgery, Kochi Medical School, Kohasu Oko-cho, Nankoku-city, Kochi 783-8505, Japan. hmaeda@kochi-u.ac.jp
Telephone: +81-88-8802370 Fax: +81-88-8802371
Received: September 23, 2013
Revised: October 29, 2013
Accepted: November 12, 2013
Published online: February 7, 2014
Processing time: 150 Days and 9.9 Hours
Abstract

Nodular fasciitis is a benign proliferative lesion composed of fibroblast-like cells that affects various sites in the body. We describe a patient with nodular fasciitis in the mesentery, encountered during laparotomy for the treatment of ascending colon cancer. The nodular fasciitis in our patient resembled peritoneal dissemination of malignancy on macroscopic observation. Because the treatment options change with concomitant peritoneal dissemination of gastrointestinal tract malignancy, recognition of this rare condition and preparation for unexpected nodular lesions are crucial.

Keywords: Colon cancer; Digestive system cancer; Laparoscopic surgery; Soft tissue neoplasms; Neoplasm metastasis; Immunohistochemistry

Core tip: Nodular fasciitis is a rare benign lesion composed of fibroblast-like cells that occurs at various sites in the body. In our patient, firm nodular lesions were incidentally identified in the mesentery during surgical treatment for colon cancer. Although the lesions were initially diagnosed as peritoneal carcinomatosis, the pathological examination revealed nodular fasciitis. This case highlights the need for all clinicians to know about this rare condition and to prepare for unexpected nodular lesions during surgical treatment of gastrointestinal tract malignancy.