Desmoid of the Abdominal Wall: Mimicking an Ovarian Mass

Abstract

Abdominal wall desmoid tumors (DTs) are a rare group of fibrous tumors of soft tissues and are locally aggressive. These tumors have a strong tendency for local invasion and recurrence without any metastatic potential. In large DTs with predominantly intra-abdominal component, the origin of mass becomes difficult to predict unless a keen observation for origin is done on advanced imaging such as magnetic resonance imaging (MRI). Surgery is the optimal treatment. We report a case of DT in a 32-year-old woman with a history of cesarean section 3 years back who presented with a chief complaint of progressive mass in the lower abdomen, noticed from the last 3 to 4 months. It was diagnosed as an ovarian mass on ultrasonography, but MRI confirmed a large abdominal wall mass. Resection of the tumor was done, and histopathology revealed a spindle cell tumor favoring fibromatosis. Large-sized DTs with predominantly intra-abdominal component may be mistaken for mass with intra-abdominal origin like uterine leiomyoma and ovarian mass as seen in our case. Therefore, careful attention is to be given to the origin if the mass is large and abutting the abdominal wall. MRI plays a crucial role in determining a diagnosis or narrowing the differential diagnosis, thus facilitating effective management.