Huge desmoid tumor of the anterior abdominal wall mimicking an intraabdominal mass in a postpartum woman: a case report

Khaled Trigui,Hassen Touinsi,Mahdi Bouassida,Selim Sassi,Houda Kilani,Mohamed Mongi Mighri,Fathi Chebbi,Sadok Sassi

doi:10.11604/pamj.2013.14.52.2414

Abstract

Desmoid tumors are benign neoplasms that most often arise from muscle aponeurosis and have been associated with both trauma and pregnancy. The etiology of desmoids has not been determined. We report the case of anterior abdominal wall desmoid tumor in a female patient with previous history of cesarean section. Preoperative ultrasound and computed tomography demonstrated a large mass mimicking a large hematoma or an intraabdominal mass. The tumor was removed by wide excision with safe margins. The abdominal wall defect was reconstructed with polypropylene mesh. Subsequent histology revealed a desmoid tumor. Desmoid tumors in females are often associated with pregnancy or occur post-partum. The reasons behind this association are unclear. The most common sites are in the abdominal muscles.

Highlights

IntroductionDesmoid tumors are rare neoplasms, accounting for 0.3% of all neoplasms and less than 3% of all soft tissue tumors with an estimated incidence in the general population of 2-4 per million of population per year [1,2,3]
The interview found no history of family or personal neoplasms, familial adenomatous polyposis (FAP), colorectal disease, no concept of hormonal contraception, alcoholism or smoking
What is most interesting about most of previous cases, and this reported here is that the desmoids arising in this situation are almost always in the abdominal wall, abdominal scars and trauma including those resulting of stretching and/or tearing of the aponeurosis in the abdominal muscles due to the pregnancy state were evoqued to be an important factor in generating such type of neoplasms, in a few cases the tumor arose elsewhere in the body [11,12,13,14]

Summary

Introduction

Desmoid tumors are rare neoplasms, accounting for 0.3% of all neoplasms and less than 3% of all soft tissue tumors with an estimated incidence in the general population of 2-4 per million of population per year [1,2,3]. The patient noticed a small tumor in the anterior abdominal wall for the first time 6 months post partum. This tumor, initially neglected by the patient, was gradually increasing in size and associated with a sustained pressure in her cesarean scar inciting the woman for consulting 10 months after its discovery. The mass was close to the left rectus abdominal muscle and after intravenous administration of contrast medium it demonstrated no enhancement even in the delayed images (Figure 1).

Discussion

Findings

Conclusion