Desmoid tumors, or aggressive fibromatoses, are rare, histologically benign tumors with biologic behavior that is intermediate between benign fibrous proliferations and low-grade fibrosarcoma. These tumors can cause significant morbidity and mortality by their propensity for local invasion and recurrence following surgical excision. A case of an anterior mediastinal desmoid tumor in a 67-year-old woman is reported with computed tomography and magnetic resonance imaging findings.
A 44-year-old female presented with a history of recurrent right-sided pneumothoraces, uterine fibroids, and a palpable lump in her navel. Total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAH-BSO) and resection of the umbilical nodule was performed. Intraoperative inspection of the right hemidiaphragm revealed adherent brownish-blue nodules without any associated diaphragmatic defects and a similar-appearing nodule at the umbilicus. She had no symptoms of pelvic endometriosis, nor did surgical exploration reveal any. Her postoperative course was uneventful and she denied recurrent pneumothorax at 12-month followup. Recurrent pneumothoraces in women of a reproductive age should raise the suspicion of thoracic endometriosis. Failure to establish the diagnosis prevents appropriate curative interventions.
Leiomyoma is the most frequent nonepithelial benign tumor of the bladder, and only about 170 cases have been reported in the literature. Most bladder wall leiomyomas are found incidentally and can be clinically followed if imaging and biopsy findings are consistent with the diagnosis. Resection is usually performed for symptomatic or enlarging masses and is indicated if the diagnosis is in question. We demonstrate imaging characteristics, port placement, operative technique, and surgical pathologic findings of the first reported case of robot-assisted laparoscopic resection of a bladder wall leiomyoma.
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