An Abdominal Wall Desmoid Tumour Mimicking Cesarean Scar Endometriomas: A Case Report and Review of the Literature

Abstract

Abdominal wall desmoid tumours (DT) are rare, slow-growing benign muscular-aponeurotic fibrous tumours with the tendency to locally invade and recur. They constitute 0.03% of all neoplasms and high infiltration and recurrence rate, but there is no metastatic potential. Although surgery is the primary treatment modality, the optimal treatment remains unclear. Abdominal wall endometriosis is also an unusual disease, and preoperative clinical diagnosis is not always easy. The preoperative radiologic imaging modalities may not aid all the time. Herein, we report an abdominal mass presenting as cyclic pain. Forty-two years old woman who gave birth by cesarean section admitted the complaints of painful abdominal mass (78x45 mm in size) under her cesarean incision scar. She had severe pain, particularly during menstruation. The clinical and radiological imaging findings mimicking endometrioma. We performed wide surgical excision of mass with a 1 cm tumor-free margin with the diagnosis of a benign mesenchymal tumor in the frozen section. The postoperative course was uneventful and recovered without any complication and recurrence three years after surgery. This report presents a case of abdominal wall desmoid tumor mimicking endometrioma. In this paper, shortcomings in diagnosis, abdominal wall endometriomas, and DTs were discussed in the view of literature.

Keywords: Abdominal wall masses; Benign mesenchymal tumor; Cesarean section; Endometriosis.

[Table/Fig-1]:

Ultrasonographic view of abdominal wall mass under cesarean incision

[Table/Fig-2]:

The view of a dense, bright beige-yellow (desmoid) tumour in the left rectus sheath

[Table/Fig-3]:

Interlacing fascicles of collagenous tissue with bland spindle cells (H&E x100)

[Table/Fig-4]:

The fascicular tumour infiltrating into the striated muscle and fat tissue (H&E x100)