Takiyama Hiroki, Nishida Tsutomu, Nakamatsu Dai, Matsumoto Kengo, Yamamoto Masashi
Department of Gastroenterology, Toyonaka Municipal Hospital, Toyonaka, JPN.
Cureus. 2024 Sep 22;16(9):e69960. doi: 10.7759/cureus.69960. eCollection 2024 Sep.
A 57-year-old male with a history of hypertension, diabetes mellitus, and dyslipidemia was found to have elevated carcinoembryonic antigen (CEA) levels during a routine health checkup, leading to an abdominal computed tomography (CT) scan. The scan identified a mesenteric mass with an irregular morphology. Subsequent blood tests indicated no signs of inflammation, and follow-up CEA levels normalized. Further imaging with abdominal contrast-enhanced CT and 18F-fluorodeoxyglucose positron emission tomography (FDG-PET)/CT revealed a calcified mass in the mesentery, raising concerns for malignancy. However, an exploratory laparotomy and biopsy confirmed the diagnosis of sclerosing mesenteritis (SM). During a 3.5-year period, the patient remained asymptomatic, with serial imaging showing no significant changes in the mass, even without treatment. This case underscores the potential benign course of SM, suggesting that conservative management may be appropriate in select asymptomatic cases.
一名57岁男性,有高血压、糖尿病和血脂异常病史,在一次常规健康检查中发现癌胚抗原(CEA)水平升高,遂进行腹部计算机断层扫描(CT)。扫描发现一个形态不规则的肠系膜肿块。随后的血液检查未显示炎症迹象,后续CEA水平恢复正常。进一步的腹部增强CT和18F-氟脱氧葡萄糖正电子发射断层扫描(FDG-PET)/CT成像显示肠系膜有一个钙化肿块,引发了对恶性肿瘤的担忧。然而,剖腹探查和活检确诊为硬化性肠系膜炎(SM)。在3.5年的时间里,患者一直无症状,系列成像显示肿块无明显变化,即使未接受治疗。该病例强调了SM可能的良性病程,表明在某些无症状病例中保守治疗可能是合适的。