A Ball in the Belly: Calcifying Fibrous Pseudotumor of Abdominal Cavity – A Rare Entity

Abstract

Calcifying fibrous pseudotumor is a rare clinically benign tumor first reported by Rosenthal and Abdul-Karim in 1988. Although rare, the tumor occurs most commonly in children and adolescents. Here we present a case of a 47-year-old male who reported to our institution with vague complaints of intermittent abdominal discomfort which was of mild to severe intensity, diffuse in presentation for a duration of 6 months. The pain was associated with subjective feeling of a “Wandering Lump” in the lower abdomen. This case report presents how this entity was managed along with review of literature. The novelty in this case report was it was a very peculiar case in the sense of its vague presentation, as the patient complained that he feels a lump and discomfort in right lower quadrant of his abdomen in the morning which moves up in the epigastric region; by evening, it comes to lie in the right lower quadrant of abdomen. So, anybody can discard this vague presentation, but in this case, we showed very high index of suspicion and evaluated him. The laparotomy confirmed its vague but true presentation as the lump was actually a freely lying ball which was wandering freely in the abdomen probably by peristalsis and patient’s routine activities. Surgical specialists are therefore advised never to miss such vague presentations, and index of suspicion has to be kept at all times.