A massive abdominal wall desmoid tumor occurring in a laparotomy scar: A case report
- PDF / 781,895 Bytes
- 4 Pages / 595.276 x 793.701 pts Page_size
- 49 Downloads / 186 Views
CASE REPORT
WORLD JOURNAL OF SURGICAL ONCOLOGY
Open Access
A massive abdominal wall desmoid tumor occurring in a laparotomy scar: A case report Joseph K Wanjeri*, Collins JO Opeya
Abstract Introduction: Desmoid tumors are benign but locally aggressive tumors of mesenchymal origin which are poorly circumscribed, infiltrate the surrounding tissue, lack a true capsule and are composed of abundant collagen. History of trauma to the site of tumor origin is elicited in up to 1 in 4 cases and they most commonly develop in the anterior abdominal wall and shoulder girdle but they can arise in any skeletal muscle. The clinical behavior and natural history of desmoid tumors are unpredictable and management is difficult with many issues remaining controversial, mainly regarding early detection, the role, type and timing of surgery and the value of non-operative therapies. Case presentation: We report a case of a 23 year old male referred from a district hospital to a national referral hospital in Kenya, after developing a huge abdominal wall desmoid tumor following laparotomy for a blunt abdominal injury fourteen months earlier. The tumor was successfully excised and the abdominal wall defect reconstructed using a vicryl/prolene mesh and a unilateral groin flap. The patient had a non-eventful recovery and was discharged through radiotherapy clinic. Conclusion: Wide margin tumor excision alone is a reasonable option in the management of desmoid tumors.
Introduction Desmoid tumors account for 0.3% of all neoplasms and less than 3% of all soft tissue tumors with the estimated incidence in the general population being 2-4 per million of population per year [1-3]. Affected patients mostly fall within the age range 10-40 years with those younger than 10 years or older than 44 being affected rarely [1]. The myofibroblast is the cell considered responsible for the development of desmoid tumors but the mechanisms of development and regulation of their growth are unknown [1,4,5]. Trauma may have a triggering effect in the development of the tumors and the tumors may be solitary or multiple [1,6]. Extra-abdominal and intra-abdominal forms of the disease have been distinguished and in abdominal wall disease, the tumor is usually confined to the musculature and the overlying aponeurosis or fascia but the neoplasm may infiltrate the surrounding tissue up to 2-3 cm outside the palpable tumor [3,7,8].
* Correspondence: [email protected] Department of Surgery, School of Medicine, University of Nairobi, Kenya
The clinical behaviour and natural history of desmoid tumors remain unpredictable and enigmatic: while in some patients it progresses rapidly and aggressively, in others it is more indolent and may remain stable without any subsequent problem for sometime [6]. Most desmoid tumors are slow-growing neoplasms that do not metastasize but aggressively invade surrounding tissues and organs or may compress surrounding structures [3,6]. Desmoid tumors often arise from the rectus abdominis muscle in postpartum women and in scars of previous
Data Loading...
