773 Desmoid Tumor in the Cecum in a Pregnant Woman

Abstract

Abstract Desmoid tumors (DT) are benign growths that invade the mesenchymal tissue locally without metastasizing. Also known as aggressive fibromatosis, these tumors tend to affect the abdomen and limbs. The etiology is still unclear, but DT happens more frequently in women during or after pregnancy. Histologically, they consist of spindle cells that are damaging locally. The gold standard treatment is complete resection, however even with this DT has a high risk of local recurrence. Due to rarity and lack of specificity on imaging, spindle cell tumors can be misdiagnosed, especially with abdominal wall endometriosis. A 36-year-old woman of Bangladeshi origin, gravida 3 and para 2, was booked into the antenatal clinic at 8 weeks gestation. This patient was thought to have a fibrothecoma, with plans to resect it during her elective cesarian. The lump was seen to be on the cecum instead and was removed. Immunohistochemical analysis of the resection pointed towards a desmoid tumor. Apparent in this case was the delay in identifying the correct diagnosis for this patient, which has profound impacts on the management. This tumor was removed in a right hemicolectomy, delayed till after the cesarian. The delay was necessary as there was no consent for a hemicolectomy and the bowel was unprepared. Interestingly, the patient did present with pregnancy complications, including an unstable lie, which questions whether there is a correlation between DT and pregnancy. Due to the rarity of this disease, there is a high need for further research into investigations and appropriate management.