Letter to the Editor

A Rare Cause of a Large Mesenteric Mass

Authors: Mehdi Akhavan-Heidari, MD, Omar Al-Nouri, DO, Douglas Henson, MD, David Denning, MD

Abstract

To the Editor:


Mesenteric lipodystrophy is a rare but benign condition that is part of a disease spectrum of idiopathic inflammatory and fibrotic changes that affect the mesentery. A 54-year-old Caucasian male presented to his family physician for a routine examination. A large midline abdominal mass was palpated in the periumbilical region. The rest of his physical examination was unremarkable. Abdominal CT scan revealed a 19 × 11 cm mass within the root of the mesentery with well-defined borders involving the mesenteric vessels. It extended from just below the pancreas down into the pelvis. Small nodular densities were also seen within the abnormal mesentery with a few foci of calcification. Due to its location, it was neither resectable nor amenable to CT-guided biopsy. The abdomen was explored via a mini-laparotomy, revealing no evidence of ascites or organomegaly. A large yellow mass was found within the root of the mesentery. Several small pieces were sent to pathology which revealed benign fibroadipose tissue showing focal areas of increased fibrosis with accompanying acute and chronic inflammation and focal fat necrosis with no malignancy, consistent with mesenteric lipodystrophy.

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