Cecal Fibromatosis (Desmoid Tumor) Mimicking Periappendicular Abscess: A Case Report

Abstract

A 32-year-old man presented to our department with abdominal pain and fever. In an earlier hospitalization he was diagnosed with periappendicular abscess and treated with antibiotics. Due to fever and ‘non-resolution’ of the abscess and due to its deep location in the lower abdomen, which excluded percutaneous drainage, we elected to operate the patient. A large mass in the cecum accompanied with an abscess resulted in a right hemicolectomy. The pathological examination revealed a desmoid tumor of the cecum. The patient’s recovery was uneventful.

Ruptured desmoid tumor imitating acute appendicitis – a rare reason for an emergency surgery

“…Again, our case was different because there was no perforation of a hollow organ but there was a rupture of the tumor pseudo-capsule with subsequent hemoperitoneum. Clinical signs such as aortic rupture, intra-abdominal abscess, or hepatic pneumatosis have also been reported [11][12][13][14].…”

Intestinal obstruction caused by desmoid tumours: a review of the literature

“…This compression can lead to intestinal obstruction, ischaemic bowel secondary to vascular compression and hydronephrosis due to ureteric compression. 10 Although intestinal obstruction has been described as a potential complication of intraabdominal desmoid tumours, only seven prior cases have been reported in the literature ( Table 1).…”

Desmoid-Type Fibromatosis of the Mesentery: Report of a Sporadic Case with Emphasis on Differential Diagnostic Problems

“…In other cases, due to ischemic events which arise in the submucosa, it may be responsible for bleeding or intestinal perforations [ 9 , 10 ]. Only rarely, clinical signs, such as aortic rupture, onset of intra-abdominal abscesses, or hepatic pneumatosis, can be encountered [ 9 , 10 , 18 ]. In our case, the tumor mass was mobile within the left abdominal region on account of its origin in the bowel mesentery, and it was the cause of intermittent abdominal pain and later of a bowel subocclusion due to infiltration of both the sigmoid colon and ileal loop.…”

“…Instead, we deemed it not possible to perform a colonoscopy (i) due to the urgency of the disease (bowel obstruction), (ii) due to the fact that, in our estimation, it would not have provided us with new information, and (iii) due to the difficulty of performing on the patient the bowel preparation in order to evaluate the colon above the stenosis. Even in the literature, however, in similar situations, colonoscopy is neither mentioned [ 11 , 12 , 18 ] nor considered a deciding factor [ 19 , 20 ].…”

“…In the literature, Walczak and Rose [ 2 ] and de Bree et al [ 26 ] report that radiotherapy should be performed only in case of incomplete resection or when margins are affected by the tumor. Regarding the adjuvant chemotherapy, revisions of desmoid-type fibromatosis case studies [ 4 , 8 ] report only a small percentage of patients submitted to it; conversely, among authors who only consider case of abdominal desmoid-type fibromatosis, Chen et al [ 13 ] alone report on most of them [ 3 , 7 , 9 – 11 , 18 – 20 , 27 ].…”