Korean J Gastroenterol.  2009 May;53(5):315-319. 10.4166/kjg.2009.53.5.315.

A Case of Desmoid Tumor Presenting as Intra-abdominal Abscess

• Yu YH
• Son BK
• Jun DW
• Kim SH
• Jo YJ
• Park YS
• Hong BW
• Joo JE

• KMID: 1767693
• DOI: http://doi.org/10.4166/kjg.2009.53.5.315

Abstract

Desmoid tumor is a rare benign tumor derived from fibrous sheath or musculoaponeurotic structure. The tumor is benign histologically but considered as malignant clinically because it has high propensity on infiltrative growth with local invasion and tendency to recurrence after local excision. Especially, when this tumor happens to be in the intra-abdomen, the prognosis is worse because it can cause intestinal obstruction, ureter obstruction and, fistula formation. It also can invade major vessels in abdomen. This tumor occurs more frequently in patients with familial adenomatous polyposis (FAP), in post-partume women, and at old surgical incision site. However, in this case, the patient had neither previous surgery nor a FAP history. We report a rare case of the young male patient who presented with an acute abdomen and underwent laparotomy and was found to have an intra-abdominal desmoid tumor with abscess formation.

Keyword

Desmoid tumor

MeSH Terms

Abdominal Abscess/diagnosis
Adult
Diagnosis, Differential
Fibromatosis, Abdominal/*diagnosis/pathology/surgery
Humans
Male
Peritoneal Neoplasms/*diagnosis/pathology/surgery
Tomography, X-Ray Computed

Figure

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  Fig. 1. Abdominal CT finding showed 9×8×10 cm large mass with air-fluid level (arrow) at left lower abdomen.

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  Fig. 2. Gross specimen findings. (A) On opening the large intestine, the mucosa revealed two dimpled foci. Arrows reveal pseudo-diver-ticulum fistular form like traction surrounded by congested firm fibrofatty tissue of mesentery (S : small intestine, L : large intestine, M: mesentery). (B) Arrows show that mesenteric mass between the colon and small intestine with marked congestion and necrotic tissue. It had central irregular space, up to 4 cm in dimension containing congested friable tissue surrounded by dense and firm fibrocollagenous tissue which was continuous to the traction diverticulous foci, and partly surrounded by severe hemorrhagic area.

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  Fig. 3. Microscopic findings. (A) Microscopic finding showed the proliferation of fibroblasts with abundant collagens (H&E stain, ×100). (B) An arrow indicates positive reaction for β-catenin staining in fibroblast (Immunohistochemical stain, ×400).

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  Fig. 4. (A, B) On gross finding, there was no stone but multiple polypoid mucoid lesions in gallbladder.

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