DESMOID TUMOUR OF ANTERIOR ABDOMINAL WALL: A CASE REPORT

Abstract

Desmoid tumours are broblastic neoplasms which show aggressive inltrative behaviour and can cause mass effect. They should be monitored for asymptomatic patient as there is a possibility of spontaneous regression. For patients with rapidly growing or symptomatic tumors resection is recommended. If complete pathologic resection is not achievable without signicant morbidity, more modest resection is recommended along with treatment with adjuvant therapies. A 36-year-old female presented to the surgery OPD with the complaint of lump in left iliac fossa for last 2 years, initially 3 x 2 cm in size but gradually increasing in size with stable vitals and examination nding of lump palpable in left iliac fossa of size 20 x 15cm, hard in consistency, not xed to skin, mobile, non-tender and becoming prominent on leg raising test. MRI pelvis was suggestive of 17.1 x 12.8 x 11.4cm, T2 hypointense lesion in left hemipelvis with extension into the hypogastrium and left iliac fossa, inltrating the left anterior abdominal wall in the left iliac fossa and hypogastrium and reaching to skin surface via large defect in the abdominal wall size, abutting and displacing the urinary bladder and left external and internal iliac vessels with the angle of contact less than 90 degrees with the vessels and left ovary not visualised separate from the lesion. FNAC was suggestive of spindle cell tumour. The patient successfully underwent wide local excision along with left oopherectomy, mesh repair and transverse rectus abdominis myocutaneous (tram) ap. Conclusion: Since, desmoid tumors are locally aggressive and invasive, timely surgical intervention with resection in this patient prevented further progression of the tumour and the high probability of invasion and involvement of major blood vessels thus signicantly reducing the fatality.