Management of Abdominal Wall and Intraabdominal Fibromatosis with Multi-organ Involvement: a Case Report

Desmoid tumors are uncommon, with an overall reported incidence of 2–5 per million population. They can be seen anywhere in the body. Desmoid tumors are associated with familial adenomatous polyposis especially with Gardner syndrome. In this study, we performed surgery for an abdominal mass involving the bladder, sigmoid colon, ileum, omentum, and rectus abdominis muscle macroscopically. A 50-year-old woman complained about abdominal distention of 1-year duration and abdominal pain for 2 months. In physical examination, tenderness was found at the lower quadrants of the abdomen and the suprapubic region. Computed tomography (CT) revealed a 43 × 43-mm mass lesion in the soft tissue densities. Magnetic resonance imaging (MRI) revealed a 43-mm lesion most likely a cyst or a sigmoid mass associated with sigmoid colon. Tumor was totally resected and pathologically diagnosed as fibromatosis. Differential diagnosis of the abdominal desmoid tumors could be difficult if the tumor is not settled in anterior preperitoneal space typically. Primary treatment of aggressive fibromatosis is surgery. Depending on the experience of the surgeon, recurrence rate varies between 25 and 65%. Radiotherapy is performed as adjuvant treatment for local control of the tumor or can be performed if the disease is extensive and local excision is not possible with surgery.