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| CASE REPORT |
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| Year : 2021 | Volume
: 16
| Issue : 2 | Page : 382-383 |
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Abdominal wall desmoid tumor diagnosis on computed tomography scan
Amruta Varma, Rajasbala P Dhande, Suhasini Pattabiraman
Department of Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, Maharashtra, India
| Date of Submission | 26-Jun-2020 |
| Date of Decision | 27-Oct-2020 |
| Date of Acceptance | 01-Dec-2020 |
| Date of Web Publication | 18-Oct-2021 |
Correspondence Address:
Dr. Amruta Varma
Department of Radiodiagnosis, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, Maharashtra
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/jdmimsu.jdmimsu_237_20
Desmoid tumor also known as aggressive fibromatosis , has similarities with malignant tumor fibrosarcoma , but are benign as they don't metastasize to other parts of body.desmoid tumoursare very rare with an incidence of 2-4 per million per year and constitute 0.03 % of all tumor . Here we are presenting a rare case of 45 year old woman who presented with pain and lump in abdomen.
Keywords: Desmoid tumor, fibromatosis, malignant tumor fibrosarcoma
How to cite this article:
Varma A, Dhande RP, Pattabiraman S. Abdominal wall desmoid tumor diagnosis on computed tomography scan. J Datta Meghe Inst Med Sci Univ 2021;16:382-3 |
| Introduction | |  |
Desmoid tumors are characterized by fibroblastic proliferation, without evidence of inflammation or definite neoplasia. Abdominal desmoids are more frequent in female patients. Desmoids have been associated with some systemic defect in connective tissue formation, with previous trauma at the site of the lesion and multiple pregnancies listed as the causative factors. An increased incidence of desmoid tumors has been found in patients with Gardner syndrome. Recurrence is common, and adjuvant radiation therapy has been recommended with local excision.
| Case Report | | |
A 45-year-old female presented with pain and a gradually progressive lump in the abdomen for 6 months in the right iliac fossa with no history of trauma. On local examination, the mass was immobile and firm in consistency with no local tenderness. She had a surgical scar mark, from her two cesarean sections. No other significant surgical history was present. In view of the above findings, she was advised computed tomography (CT) scan as shown in [Figure 1] and post operative specimen as shown in [Figure 2]. On CT, there was evidence of a well-circumscribed heterogeneously enhancing mass lesion with poorly enhancing central area noted in the anterior abdominal wall toward the right inguinal region, appearing to be arising from the right rectus abdominis muscle measuring approximately 6.6 cm × 6.5 cm × 4.7 cm. | Figure 1: (a) A well-circumscribed heterogeneously enhancing mass lesion with poorly enhancing central area in the anterior abdominal wall toward the right inguinal region, appearing to be arising from the right rectus abdominis muscle measuring approximately 6.6 cm × 6.5 cm × 4.7 cm. (b) Noncontrast computed tomography scan image showing a well-defined mass lesion arising from the right rectus abdominis muscle
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| Discussion | | |
CT and magnetic resonance imaging are very useful to locate the extent and size of desmoid tumors before surgical resection. Abdominal wall desmoid tumors originate from musculoaponeurotic structures of the abdominal wall, mostly the rectus and internal oblique muscles and their fascial coverings. Sometimes, desmoids can cross the midline to involve both rectus muscles. Rarely, they can arise from the external oblique muscle and the transversalis muscle or fascia. Moreover, its extension to the inner surface of the iliac crest and into the abdominal cavity can occur. Typically, these tumors are seen in young age, gravid women, or more commonly during the 1st year after childbirth. They may also originate from areas of previous abdominal surgery. Most of the abdominal wall desmoids measure up to 5–15 cm.[1] When they arise in the rectus muscle, they usually remain at their site of origin. Its recurrence is 20%–30%[1] and usually becomes evident within 6 months after excision or in connection with subsequent gestations or deliveries.[2]
The differential diagnosis of desmoid tumors is shown in [Table 1].[2]
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | Wetzel LH, Levine E. Soft-tissue tumors of the foot: Value of MR imaging for specific diagnosis. AJR Am J Roentgenol 1990;155:1025-30.  |
| 2. | Casillas J, Sais GJ, Greve JL, Iparraguirre MC, Morillo G. Imaging of intra- and extraabdominal desmoid tumors. Radiographics 1991;11:959-68. |
[Figure 1], [Figure 2]
[Table 1]
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