A case of intestinal obstruction in a middle aged woman – a pathological surprise

Background: Fibromatosis is a tumour of fibroblasts and myofibroblasts with a tendency of local invasion and recurrence but no malignant potential and is classified as superficial or deep. Intra-abdominal fibrosis, a type of deep fibromatosis, is a rare cause of intestinal obstruction. We report intestinal obstruction in a middle aged woman caused by jejunal/mesenteric fibromatosis. Case presentation: An early 40s woman presented with intestinal obstruction and a month-long history of abdominal pain. She required emergency surgical intervention which uncovered an obstructive mass involving the jejunum and adjacent mesentery. Histology of the resected tumor with wide surgical margins revealed fibromatosis with positive nuclear â-catenin immunohistochemistry. Conclusion: Fibromatosis is a rare cause of intestinal obstruction. Awareness of the condition and recognition of the myriad histological features is important for accurate diagnosis and distinction from its mimickers. Positive nuclear staining of tumour cells for â-catenin is an important clue to diagnosis. Distinction from other causes of intestinal obstruction is paramount for implications on different modalities of management and prognosis.