Desmoid tumor arising in a laparoscopic trocar site

Desmoid tumors are fibrotic neoplasms of low metastatic potential. These tumors have long been associated with major laparotomy incisions. However, to the best of our knowledge, they have not been previously associated with laparoscopic trocar placement. This report involves the case of a patient who developed a desmoid tumor at a trocar site. A 35 year-old premenopausal woman presented with an enlarging infraumbilical mass 10 years after a laparoscopic tubal ligation. The mass was immediately subjacent to the skin incision for the laparoscopic procedure. It was approximately 6 cm in diameter and fixed to the underlying abdominal wall. It was evaluated with sonographic and CT imaging, which revealed a solid mass arising from the fascia with no associated hernia. A biopsy of the mass confirmed a diagnosis of a desmoid tumor. This was subsequently excised with a wide margin and reconstructed with Marlex mesh. The patient is without recurrence 2 years following surgery. This case represents what we believe to be the first report of a desmoid tumor arising from a incision made for the placement of a laparoscopic port. Rapidly increasing laparoscopic applications make it likely that these lesions will increase in frequency. In this setting, resection with wide margins remains the mainstay of treatment for desmoid tumors.