SUMMARYDesmoid tumor is a rare, benign fibroblastic tumor that is characterized by highly aggressive local invasiveness.The authors report the case of a 35 year old male who presented with a 20 cm para-umbilical tumor invading the right rectus abdominis muscle. This required a wide excision of the abdominal wall. The resulting defect was closed with a single-stage latissimus dorsi myocutaneous free flap in combination with a prosthetic mesh reconstruction.The authors discuss the therapeutic options for management of these rare tumors and the variety of available techniques for coverage and reconstruction after extensive parietal loss of substance. KeywordsAbdominal wall; Loss of substance; Reconstruction of the abdominal wall; Latissimus dorsi free flap; Desmoid tumor; Fibromatosis Desmoid tumors are histologically benign but agressive non-encapsulated tumors consisting of well-differentiated fibroblastic cells in a collagen matrix ; they arise from the surface of a fascial or musculo-aponeurotic structure. CASE REPORTA 35 year old male presented with a 20 cm diameter tumor which was noticed after a recent traumatic episode. Family history was non-contributory. The patient described steady growth of the mass over a four month period. It was located in the right para-umbilical region [ fig.1]. There was no palpable lymphadenopathy. The patient had noted no signs of obstruction or problems with intestinal transit.Fine-needle aspiration cytology revealed fusiform cells suggestive of two possible diagnoses, sarcoma or desmoid tumor. Ultrasound showed the tumor to be heterogeneous and hypervascular on doppler exam. MRI was a critical study for the pre-operative

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