Published online Apr 16, 2016. doi: 10.12998/wjcc.v4.i4.108
Peer-review started: October 14, 2015
First decision: November 11, 2015
Revised: December 6, 2015
Accepted: January 8, 2016
Article in press: January 11, 2016
Published online: April 16, 2016
An unusual case of long standing sclerosing mesenteritis; initially presented with recurrent abdominal pain and a mesenteric mass with surrounding fat oedema and stranding with a pseudocapsule and fat ring sign were clearly visualised on the initial computed tomography scan. Laparotomy showed diffuse thickening at the root of the mesentery and histology from this specimen revealed fat necrosis and reactive lymphoid tissue consistent with sclerosing mesenteritis. Initial treatment with steroids and tamoxifen relieved the symptoms and the mass. He was maintained on tamoxifen. Three years later he developed a recurrence of his symptoms and abdominal mass that responded to a course of steroids. Two years following this, he developed a follicular Hodgkin’s lymphoma.
Core tip: Sclerosing mesenteritis is a rare disease but clinicians should be mindful of this condition that can present with various clinical symptoms including recurrent abdominal pain. The case we describe showed typical features of sclerosing mesenteritis and demonstrated good clinical and radiological response to steroids and tamoxifen. Five years later he developed a recurrence of the abdominal mass that showed transformation into a lymphoma.