Desmoid Fibromatosis Infiltrating Left Adrenal Gland and Kidney

Abstract

Desmoid fibromatosis is a rare, benign, locally aggressive fibroblastic proliferation that may occur in almost any anatomical location. Due to its rarity and unpredictable clinical course, there has not been a standard guideline for treatment. We encountered a case of desmoid fibromatosis in our center. A 25 years old lady with no previous comorbid was referred for a symptomatic, rapidly growing left-sided abdominal mass. Otherwise, she denied any bowel-related symptoms or constitutional manifestation. Clinically, the abdominal was soft, but a 10x10 cm mass was palpable over the left flank. Imaging showed a large well-defined lobulated solid-cystic mass extending from vertebral level T10 to L5, measuring 10.5x15x23cm. The mass was in close proximity to the left adrenal gland, left kidney, pancreas, and spleen. Ultrasound guided biopsy interpreted it as a fibroblastic or myelofibroblastic tumour, favouring desmoid fibromatosis. Surgery was then performed where the mass was removed along with the left adrenal gland and kidney. Post-operative care was complicated with pulmonary embolism, pancreatitis, and abdominal collection, which was subsequently drained under ultrasound guidance. She was then referred to the oncology team for radiotherapy.