An Intra-Abdominal Desmoid Tumor, Embedded in the Pancreas, Preoperatively Diagnosed as an Extragastric Growing Gastrointestinal Stromal Tumor

Abstract

A 45-year-old woman was found to have a pancreatic tumor by abdominal ultrasound performed for a medical check-up. Abdominal contrast-enhanced computed tomography showed a hypovascular tumor measuring 30 mm in diameter in the pancreatic tail. Endoscopic ultrasound-guided fine needle aspiration was performed. An extragastric growing gastrointestinal stromal tumor was thereby diagnosed preoperatively, and surgical resection was planned. Laparoscopic surgery was attempted but conversion to open surgery was necessitated by extensive adhesions, and distal pancreatectomy, splenectomy, and partial gastrectomy were performed. The histological diagnosis was an intra-abdominal desmoid tumor. A desmoid tumor is a fibrous soft tissue tumor arising in the fascia and musculoaponeurotic tissues. It usually occurs in the extremities and abdominal wall, and only rarely in the abdominal cavity. We experienced a case with an intra-abdominal desmoid tumor that was histologically diagnosed after laparotomy, which had been preoperatively diagnosed as an extragastric growing gastrointestinal stromal tumor. Although rare, desmoid tumors should be considered in the differential diagnosis of intra-abdominal tumors. Herein, we report this case with a literature review.

<i>En bloc</i> resection for intra-abdominal/retroperitoneal desmoid-type fibromatosis with adjacent organ involvement: A case series and literature review

“…No DF-related death was noted during the follow-up. Among the 23 patients previously reviewed, grade III-V postoperative morbidity occurred in only 1 of the patients, and no patient developed local recurrence and died during the followup (Table 4) (23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42). Based on the above results, en bloc resection in IA/RPDF with adjacent organ involvement is a safe and effective treatment modality.…”

“…However, most of the results of previous studies were based on the analysis of extraabdominal DF (1,2,(8)(9)(10)(11). There are limited studies on IA/RPDF, and most previous studies were case reports (Table 4) (23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42). A case series of IA/RPDF treated with en bloc resection of the tumor with adhesive organs is reported for the first time in this study.…”

Postoperative developed intra-abdominal desmoid tumor after surgical resection of gastrointestinal malignancy: A review of 10 cases

“…As the preoperative diagnosis of intra-abdominal desmoid tumor is difficult with no specific characteristic imaging findings [10], so it is difficult to differentiate between desmoid and tumor recurrence particularly in patients with previous surgical resection of abdominal malignancy. The current study aimed to distinguish between desmoid tumors and tumor recurrence.…”

“…Many treatment options for abdominal desmoid tumors are addressed. Complete surgical excision with wide surgical margins (at least 1 cm) is often the first line therapy for resectable tumors [10,17]. Most patients require an individualized treatment approach.…”

Successful outcomes after laparoscopic spleen-preserving pancreatic resection for a desmoid tumor: A case report

“…These tumors are locally aggressive but do not metastasize [ 1 ]. The reported incidence ranges from 2.4 to 4.3 per 1,000,000 individuals/year [ 2 ]. Isolated pancreatic desmoid tumors are extremely rare.…”