Diagnostic and therapeutic dilemmas in intra-abdominal desmoid tumors: A case report and literature review

Abstract

HighlightsDesmoid tumors are benign but lead to morbidity and mortality due to mass effect.Histologically, desmoid tumors can masquerade as other neoplastic processes.Chemo- and radio-therapy are useful, but surgery is the cornerstone of therapy.The recurrence rate, even after treatment, is high.

Giant Intra-Abdominal Desmoid Tumor in a Young Male without History of Surgery, Trauma, or Familial Adenomatous Polyposis

“…For diagnosis of DTs, especially intraabdominal DTs, representative symptoms are intestinal obstruction, bowel ischemia, and abdominal distention [ 1 ]. Many patients with intra-abdominal DTs who had no family history of colon cancer and no personal history of abdominal trauma receive diagnosis without symptoms [ 2 ]. If the patients have history of FAP and abdominal trauma, the DTs can easily be given differential diagnosis.…”

“…Regarding treatment, the optimal therapy for DTs is also difficult to ascertain. DTs are rare, and anatomical presentation is varied, so large randomized trial studies are difficult [ 1 , 2 , 8 ]. Close observation is an acceptable strategy for stable asymptomatic patients (watchful waiting) [ 1 – 3 , 5 , 8 ].…”

“…Close observation is an acceptable strategy for stable asymptomatic patients (watchful waiting) [ 1 – 3 , 5 , 8 ]. If the patient has symptoms, however, the optimal therapy is complete surgical resection with negative margin when medically and technically feasible [ 2 , 3 ]. Our patient had symptoms, but definitive diagnosis was not possible, so surgical resection was the optimal treatment.…”

“…They are rare; the incidence in the general population is 2–4 cases per million people per year [ 1 ]. DTs are typically sporadic and can occur anywhere in the body [ 1 , 2 ]. They are reportedly associated with surgery, trauma, pregnancy, and familial adenomatous polyposis (FAP) [ 1 , 2 ].…”

“…We performed surgical resection of the tumor with partial resection of the stomach and pancreatic tail. DTs have invasive development, and many recur locally, so it is thought that complete resection with a negative margin is important [ 1 , 2 ].…”