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Joseph Junewick, MD FACR
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Desmoid Tumor

Case Detail

Anatomy: Musculoskeletal
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Neoplasia Benign
Created: over 7 years ago
Updated: over 7 years ago
Tags: PEDS
Modality/Study Types: CT
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History

Teenage female with palpable abdominal mass.


Case Images


Diagnosis

Desmoid Tumor

Findings

CT – Well-circumscribed abdominal wall mass with variable enhancement. The abdominal wall origin can be determined because the inferior epigastric vessel are inwardly displaced the mass.

Discussion

Desmoid is a fibroblastic tumor. Histologically these tumors are benign but locally infiltrative and aggressive. Abdominal wall desmoids arise from the aponeurosis of the abdominal wall musculature; 87% occur in women and are associated with estrogenic hormones (pregnancy or birth control pills). Trauma may be a contributory cause. Abdominal wall desmoids can also be seen in patients with familial adenomatous polyposis.

Abdominal wall desmoids most often arise from the aponeurosis of the rectus abdominus and internal oblique muscles. Lesions can occasionally cross the midline or have intra-abdominal extension.

Wide margin resection is the treatment of choice. Recurrence rate is between 20 and 30% which is lower than extra-abdominal desmoids. Antiestrogen, progesterone, lutein-releasing hormone and testosterone have been used in the management.

Reference

Levy AD, et al. From the archives of the AFIP: Benign fibrous tumors and tumorlike lesions of the mesentery: Radiologic-pathologic correlation. Radiographics 2006; 26(1):245-264.

Einstein DM, Tagliabue JR, Desai RK. Abdominal desmoids: CT findings in 25 patients. AJR 1991; 157:275-279.

Murphy MD, et al. Musculoskeletal fibromatoses: Radiologic-pathologic correlation. Radiographics (2009); 29(7):2143-2176.



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