An intra-abdominal desmoid tumour: Case report

Desmoid tumours typically arise in the abdomen and extremities. They are rare, originating from mesenchymal cells, with intra-abdominal desmoid tumours (DT) being even less common. While non-malignant and non-metastatic, they can be locally invasive, often necessitating surgical intervention for complete resection.

We present the case of a 26-year-old woman referred to our emergency department with pelvic pain three months after cesarean delivery. Abdominal computed tomography revealed a 7 cm retro-uterine mass extending to the right colon, appendix, and cecum. Although MRI suggested an intra-mesenteric benign tumour, a definitive diagnosis was not established. Surgical excision was performed for both diagnostic and therapeutic purposes, revealing a 5.5 cm desmoid tumour infiltrating adipose and muscular tissue of the last ileal loop, with negative resection margins. Postoperative recovery was uneventful, and the patient is under CT surveillance.

Intra-abdominal DTs are exceedingly rare and can present with a spectrum of symptoms. Imaging findings may mimic other conditions, making diagnosis challenging. Surgical expertise is crucial for optimal management, with complete resection being the primary therapeutic approach.

In conclusion, intra-abdominal desmoid tumours are rare entities that pose diagnostic and therapeutic challenges. Surgeons experienced in handling such cases are essential for achieving favourable outcomes. Continued surveillance is necessary due to the potential for recurrence.