Abstract
IntroductionDesmoid tumors are benign but locally aggressive tumors of mesenchymal origin which are poorly circumscribed, infiltrate the surrounding tissue, lack a true capsule and are composed of abundant collagen. History of trauma to the site of tumor origin is elicited in up to 1 in 4 cases and they most commonly develop in the anterior abdominal wall and shoulder girdle but they can arise in any skeletal muscle. The clinical behavior and natural history of desmoid tumors are unpredictable and management is difficult with many issues remaining controversial, mainly regarding early detection, the role, type and timing of surgery and the value of non-operative therapies.Case presentationWe report a case of a 23 year old male referred from a district hospital to a national referral hospital in Kenya, after developing a huge abdominal wall desmoid tumor following laparotomy for a blunt abdominal injury fourteen months earlier. The tumor was successfully excised and the abdominal wall defect reconstructed using a vicryl/prolene mesh and a unilateral groin flap. The patient had a non-eventful recovery and was discharged through radiotherapy clinic.ConclusionWide margin tumor excision alone is a reasonable option in the management of desmoid tumors.
Highlights
Desmoid tumors are benign but locally aggressive tumors of mesenchymal origin which are poorly circumscribed, infiltrate the surrounding tissue, lack a true capsule and are composed of abundant collagen
Wide margin tumor excision alone is a reasonable option in the management of desmoid tumors
Desmoid tumors account for 0.3% of all neoplasms and less than 3% of all soft tissue tumors with the estimated incidence in the general population being 2-4 per million of population per year [1,2,3]
Summary
Desmoid tumors account for 0.3% of all neoplasms and less than 3% of all soft tissue tumors with the estimated incidence in the general population being 2-4 per million of population per year [1,2,3]. Case presentation The patient was a 23 year old male who presented with an anterior abdominal wall mass in December 2007 following an emergency laparotomy for blunt abdominal trauma in June 2006. He was referred to Kenyatta National Hospital from a district hospital where an incisional biopsy had been done and reported as benign. There was no family history of Familial Adenomatous Polyposis (FAP), colorectal disease or similar condition in any of the close relatives On examination, his general condition was fair and he had a huge ulcerated anterior abdominal wall mass with everted edges measuring 16 cm × 20 cm (figure 1) which was reported as desmoid tumor after incisional biopsy was done. The authors traced him thirty months later and found him without any sign of recurrence but he had an incisional hernia at the site of tumor excision and repair (figure 5)
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