S1801 Got It From My Mama: Case Report of Mesenteric Adenocarcinoma

Abstract

INTRODUCTION: Mesenteric tumors are uncommon. They arise from peritoneum, lymphatic, fat, and connective tissue. Generally, consist of nonneoplastic or neoplastic tumors. We report a case of an unusual mesenteric adenocarcinoma. CASE DESCRIPTION/METHODS: A 83-year-old female presented for a routine surveillance colonoscopy. She had undergone right hemicolectomy (2015) for stage II colon cancer (T3N0M0). She had a strong family history of cancer: colon and pancreatic cancer ( mother), rectal cancer (brother) and lung cancer (sister). She had previously undergone TAH BSO (1999). She presented with vague epigastric discomfort and post prandial pain but had no nausea, vomiting or weight loss. CT scan revealed a focal mass with rim enhancement near the inferior aspect of the pancreatic body measuring 4 cm × 3.7 cm and wall thickening of the gastric antrum. On EGD 4 nonbleeding antral ulcers were seen. EUS demonstrated a 5.2 × 3.6 cm irregular mass near the pancreatic neck, heterogenous and cystic but separate from the pancreas. FNA positive for adenocarcinoma. On PET scan a centrally necrotic neoplasm of the right mid abdomen was identified. CEA and CA19-9 were not elevated, HGB and LFTs were normal. At the time of this abstract the patient was receiving neoadjuvant chemotherapy. DISCUSSION: Mesenteric tumors consist of peritoneal cysts, enteric cysts, mesenteric mesotheliomas, mesenteric lipodystrophy, lymphangiomas, desmoid tumors (associated with FAP & Gardner syndrome), mesenteric lymphoma, mesenteric Carcinoid tumors & metastatic tumors. Medical evaluation consists of clinical examination, imagery and histopathology. Therapeutic management vary from observation, medical therapy to surgery: (Dufray et al. 239).This case underscores the importance of a thorough post-operative surveillance in patients with colo-rectal cancer. Implementation of postoperative surveillance guideline recommendations will potentially aide with early detection of metachronous colorectal lesions and other primary neoplasm in other organ systems.