Concurrence of abdominal wall desmoid tumor with uterine sub-serosal fibroid: A rare case report from Nepal

Summary

Introduction and importance: Abdominal wall desmoid tumors are rare within itself, and its concurrence with uterine sub-serosal fibroid and management in a single setting is not reported. The incidence of desmoid tumors is 2-5 cases per million. Case presentation: A 50-year-old normally menstruating woman presented with insidious onset, dull aching abdominal pain for two and a half months. A bulge was seen, and a mass of 31 × 38 cm with an irregular margin and firm consistency was found on palpation. Abdominal computed tomography (CT) revealed a heterogenous lesion measuring 23.2 × 22.5 × 8.5 cm in the anterior abdominal wall with fat stranding and a well-defined hypodense lesion in the left side of the uterus measuring 7.29 × 5.6 × 4.8 cm. Laparotomy and excision of abdominal wall mass with myomectomy and bilateral salpingectomy were performed. Discussion: Desmoid tumors (DT) are rare tumors comprising 0.03 % of all neoplasms and 3 % of all soft tissue tumors. Clinical manifestation of DT includes a painless plaque or firm lump and may be associated with pressure symptoms. Fibroids may also cause pressure symptoms or present as a symptomless mass, making the diagnosis confusing. Surgery is the definite treatment, but recurrence may occur. Conclusion: Combined efforts between surgeons and gynecologists are required if concurrence of abdominal wall tumors occur along with fibroids.