Desmoid Tumor of the Popliteal Fossa during Pregnancy

Abstract

Desmoid tumors are fibroblastic neoplasms that have an intermediate behavior with a highly aggressive infiltrative growth arising from deep muscle or aponeurosis. We present the case of a 34-year-old woman that developed a painless mass in the right popliteal fossa during pregnancy after intracytoplasmic sperm injection and hormonal therapy. The MRI scan showed a hyperintense mass of 6,7 cm × 4,7 cm × 3,8 cm surrounding the lateral head of the gastrocnemius muscle. The open biopsy was done one week after delivery, and the histology showed a desmoid tumor. We performed the resection one week later and found the common peroneal nerve completely surrounded by the tumor. The close resection due to the neurolysis was the reason why an adjuvant radiation with 56 Gy was done. The last clinical examination, 18 month later, did not show any signs of recurrence and an excellent functional outcome. This case demonstrates the possible influences of pregnancy and hormonal therapy on the evolution of desmoid tumors.

Recurrent desmoid-type fibromatosis associated with underlying neuromuscular choristoma

“…Although lacking metastatic potential, it typically widely infiltrates into soft tissues, frequently encompassing neurovascular structures. [3][4][5]12,[23][24][25]27,[29][30][31][32] It can compress, encompass, or invade nerves or track along them, making it difficult to achieve complete excision without compromising nerve function. Recurrence typically happens locally but can occur at distant sites as well, either synchronously or metachronously.…”

A Case of Painful Growing Abdominal Wall Mass during Pregnancy Requiring Resection in the Second Trimester

“…Out of the 50 cases in the study, the most common site was the abdominal muscles, particularly the right rectus muscle [ 12 ]. There are rare cases reported of desmoid tumors in extra-abdominal sites such as the vulva, larynx, neck, and popliteal fossa [ 13 , 14 ]. Furthermore, a recent study involving 382 patients with desmoid-type fibromatosis found that the prevalence of pain was only 36%, thereby highlighting the relatively uncommon nature of this symptom in the condition [ 15 ].…”

Value of imaging findings in predicting post‑operative recurrence of desmoid‑type fibromatosis

“…With an incidence rate of approximately five per million people annually, it is uncommon, representing approximately 0.3 per cent of all soft tissue neoplasms (18,19). While the exact causes remain elusive, desmoid-type fibromatosis is currently considered to be associated with surgical history, traumatic injury, familial adenomatous polyposis and Gardner's syndrome (10). Women were more likely to develop the disease compared with men (20), and therefore, estrogen is an influencing factor.…”

“…The most common complaints of patients are painless progressive growth of the mass, neurological dysfunction, joint stiffness and abdominal discomfort due to the tumor growth (9). The imaging findings of desmoid-type fibromatosis depend on the number of fibroblasts proliferating in the tumor, as well as the fiber composition, collagen content and tumor supply (10). Areas of dense fibrous tissue and scar-like collagen fiber deposition usually show low signal for T1WI and T2WI, and no enhancement after injection of contrast agent (11).…”