Complete resection of a rectus abdominis muscle invaded by desmoid tumors and subsequent management with an abdominal binder: a case report

Abstract

BackgroundDesmoid-type fibromatosis is characterized by desmoid tumors, which are benign soft tissue tumors that can be locally aggressive but typically do not metastasize. Desmoid tumors can manifest anywhere in the body, and those in the abdominal cavity account for approximately 30 to 50% of all such tumors. Complete resection with free margins has been the standard treatment, but non-surgical therapies have been implemented recently. However, if tumors are strongly invasive and/or persistently recur, radical surgical resection with free margins remains the primary treatment. Unfortunately, radical resection may cause large abdominal defects and hinder reconstruction. Several reports and recommendations have addressed this issue; however, to the best of our knowledge, few reports have described complete resection and the subsequent reconstruction of the rectus abdominis muscle.Case presentationA 35-year-old Asian woman presented at our hospital with a chief complaint of abdominal pain. She had abdominal desmoid tumors that required complete resection of her rectus abdominis muscle. Due to necrosis in her own reconstructed tissue, we failed to cover her anterior abdominal wall; thus, we used an abdominal binder as a substitute material to avoid exacerbating the incisional hernia and help her generate intra-abdominal pressure.ConclusionsThis case report may be informative and helpful for the treatment of patients with desmoid tumors, as managing desmoid-type fibromatosis is difficult.

Effects of an abdominal binder on the development of incisional hernia in the long term: A prospective cohort study

“…Gustafsson et al 29 noted that guidelines for perioperative care in elective colonic surgery reported the positive effects of abdominal binders on wound healing. A case study by Ogawa 30 on a patient with desmoid tumours reported that an abdominal binder protected abdominal organs and maintained a proper posture, which, in turn, resulted in a high quality of life. In our study, there was no statistically significant difference between the participants who used and did not use abdominal binders in terms of the development of IH.…”

Management of aggressive fibromatosis (Review)

“…Surgery is the first-line treatment for tumors with a clear margin in most cases ( 17 ). It was found that patients in case reports with intra-abdominal desmoids attain a non-recurrent duration varying from <12 months ( 18 ) to 30 months ( 19 ), excluding those who were lost to follow up and cases that were not mentioned. In addition, the local recurrence rate is 8–31% ( 20 , 21 ) after surgery with a clear margin.…”