Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Sep 3;14(9):e244361.
doi: 10.1136/bcr-2021-244361.

Surgical management of a giant abdominal wall desmoid tumour

Nandesh Patel  1 , Ralitsa Slivkova  1 , Sunil James  2   3 , Max Almond  3
Affiliations
Case Reports

Surgical management of a giant abdominal wall desmoid tumour

Nandesh Patel et al. BMJ Case Rep. .

Abstract

Desmoid tumours are clonal fibroblastic proliferations in soft tissues, characterised by infiltrative growth and local recurrence, but not metastasis. Various treatment strategies for desmoid tumours exist, varying from observation, medical and systemic therapy to radiotherapy and surgery. A 25-year-old woman with a background of familial adenomatous polyposis was referred with an enlarging abdominal desmoid tumour measuring 40×40×40 cm despite repeated radiofrequency ablation, surgical debulking and hormone therapy. The patient had a two-stage operation. The first stage involved excision of the desmoid tumour with full-thickness abdominal wall. The abdominal wall was not closed, and a topical negative pressure seal was applied. After 2 days, she underwent the second stage: reconstruction of the abdominal wall defect with a large porcine mesh which was covered with anterolateral thigh flaps. Postoperative complications included ileus and a fall which required further surgery. The patient was discharged 1 month after the first operation. Abdominal MRI scans were performed at 3 and 7 months postdischarge and showed no recurrence of diseaseBackground.

Keywords: gastrointestinal surgery; general surgery; plastic and reconstructive surgery.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Computerised topography imaging of the patient’s tumour (preoperatively). (A) Transverse imaging of the tumour. (B) Sagittal section of the tumour.
Figure 2
Figure 2
Images taken on day 1 of the operation. (A) Tumour preoperation. (B) Tumour separation from abdominal viscera. (C) Postresection of the tumour and abdominal viscera covered with gauze. (D) Unclosed abdominal wall with topical negative pressure.
Figure 3
Figure 3
Images taken on day 2 of operation. (A, C) Abdominal viscera after negative pressure was removed. (B, D) Initial stages of abdominal wall reconstruction.
Figure 4
Figure 4
Images of abdominal wall reconstruction on day 2. (A) Closer of abdominal wall using thigh flaps. (B) Final abdominal wall after closure. (C) Anterolateral thigh flaps used to construct the abdominal flap.
Figure 5
Figure 5
Postoperative magnetic resonance images. (A) Transverse and (B) sagittal planes of the patient postoperation.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Desmoid Tumor Working Group . The management of desmoid tumours: a joint global consensus-based guideline approach for adult and paediatric patients. Eur J Cancer 2020;127:96–107. 10.1016/j.ejca.2019.11.013 - DOI - PubMed
    1. van Broekhoven DLM, Grünhagen DJ, den Bakker MA, et al. . Time trends in the incidence and treatment of extra-abdominal and abdominal aggressive fibromatosis: a population-based study. Ann Surg Oncol 2015;22:2817–23. 10.1245/s10434-015-4632-y - DOI - PMC - PubMed
    1. Penel N, Coindre J-M, Bonvalot S, et al. . Management of desmoid tumours: a nationwide survey of labelled reference centre networks in France. Eur J Cancer 2016;58:90–6. 10.1016/j.ejca.2016.02.008 - DOI - PubMed
    1. Kasper B, Ströbel P, Hohenberger P. Desmoid tumors: clinical features and treatment options for advanced disease. Oncologist 2011;16:682–93. 10.1634/theoncologist.2010-0281 - DOI - PMC - PubMed
    1. Howard JH, Pollock RE. Intra-Abdominal and abdominal wall desmoid fibromatosis. Oncol Ther 2016;4:57–72. 10.1007/s40487-016-0017-z - DOI - PMC - PubMed

Publication types