Wide local excision and reconstructive surgery of desmoid tumour of the crus (Case report)

Abstract

Extra-abdominal desmoid tumour is a rare type of tumour which is conventionally treated with wide local excision. However, wide local excision usually causes irreparable damage to the limbs. Nevertheless, few patients have been subjected to wide local excision and reconstructive surgery in a single procedure. A 52-year-old female reported a slow-growing lump in the right crus which had been growing for two years. The patient complained of persistent pain, especially at night, and was first subjected to lump resection in another hospital. The postoperative histopathological examination indicated muscle fibroma. Three months later, the lump recurred in the same position. The persistent pain induced by the tumour hampered her ability to walk. Wide local excision was conducted on the major parts of the gastrocnemius and soleus. After the pathological examination confirmed that the resection margin was negative, we performed reconstructive surgery on the Achilles tendon. The patient recovered plantarflexion function following the surgery and did not report any recurrence in the 6-year follow-up period. The desmoid tumour is a low-grade malignant tumour. Thus, the main focus of the treatment is to restore the function of the limbs to optimal capacity, such that the incidence of tumour recurrence is minimised.