Xinsheng Zhang, Xiping Yu, Danni Dong, Jibo Hu, Houyun Xu
Aggressive Fibromatosis (AF) is a rare mesenchymal tumor characterized by nuclear β-catenin positivity. Its exact etiology remains unclear but is thought to be associated with hormonal factors, trauma, or prior surgery. Clinically, AF is uncommon and demonstrates nonspecific imaging features, frequently complicating preoperative diagnosis. This is particularly true for intra-abdominal AF presenting with atypical features, which can be easily mistaken for other abdominal space-occupying lesions. Herein, we report two rare cases of primary intestinal AF, one of which was complicated by tumor rupture and subsequent intra-abdominal abscess formation. Through an integrated analysis of clinical presentation, imaging findings, and pathological results, this report discusses the diagnostic considerations and management strategies for AF.