Abstract
BackgroundIntra-abdominal desmoid tumors, particularly those derived from the stomach, are rare. Such tumors are associated with a history of familial adenomatous polyposis (FAP), trauma, or surgical procedures in general. In addition, spontaneous shrinking of an intra-abdominal desmoid tumor is rarer. And desmoid tumors most commonly arise during the fourth decade of life.Case presentationA 17-year-old boy with lower abdominal pain was diagnosed with a gastrointestinal stromal tumor (GIST) or a hematoma at a local hospital. He had no history of FAP, trauma, or previous surgery. Abdominal computed tomography (CT) was performed for observational purposes three times over a 9-month period. The tumor gradually decreased in size over time; however, the tumor did not shrink sufficiently to be diagnosed as a hematoma. Because there was a high possibility of a GIST from the stomach, he underwent laparotomy. Operative findings revealed that the tumor was a hard mass firmly attached to both the greater curvature of the stomach and the inferior pole of the spleen. Pathologically, the tumor was diagnosed as a desmoid tumor derived from the stomach.ConclusionFor a young boy without a history of FAP, trauma, or surgical procedures, it is difficult to define an intra-abdominal tumor near the stomach as a desmoid tumor. In such cases, surgical resection is recommended for a definitive diagnosis.
Highlights
Intra-abdominal desmoid tumors, those derived from the stomach, are rare
Desmoid tumors are well known to be associated with familial adenomatous polyposis (FAP), with an incidence 1000fold greater among individuals with FAP than among individuals without this condition
We report a rare case of an intra-abdominal desmoid tumor derived from the stomach in a young patient without a history of FAP, trauma, or surgery
Summary
Desmoid tumors were first described in 1832 by MacFarlane [1] and account for 0.03% of neoplasms and 3% of soft tissue tumors [2]. The tumor had gradually shrunk, we could not definitively establish a diagnosis of a hematoma, as opposed to a GIST During observation, he had no any symptoms including lower abdominal pain. Operative findings revealed that the tumor was a hard mass and was firmly attached to the greater curvature of the stomach and the inferior pole of the spleen (Fig. 2a, b). It was unclear whether this firm attachment was attributable to adhesion or direct invasion. Immunohistological examination showed that the tumor was negative for CD34, CD117 (C-kit), desmin, S-100, and β-catenin (Fig. 4b–f ) This tumor was eventually diagnosed as a desmoid tumor derived from the stomach. He continues to undergo surveillance for recurrence, and no signs of recurrence have been observed for 16 months after the operation
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