Diagnostic and therapeutic dilemmas in intra-abdominal desmoid tumors: A case report and literature review

• Desmoid tumors are benign but lead to morbidity and mortality due to mass effect.
• Histologically, desmoid tumors can masquerade as other neoplastic processes.
• Chemo- and radio-therapy are useful, but surgery is the cornerstone of therapy.
• The recurrence rate, even after treatment, is high.

IntroductionIntra-abdominal desmoid tumors (DTs) are a rare and anatomically diverse group of locally-aggressive, benign neoplasms. They are often difficult to diagnose, even in patients who possess risk factors for the disease. Even after a diagnosis has been reached, the optimal therapy is often not well-defined.Presentation of caseThe case discussed of a 33-year old male with a giant intra-abdominal desmoid is an example of both the diagnostic and therapeutic dilemmas that arise when confronted with a patient with a DT. Initial confusion over diagnosis led to ineffective therapy, but once the correct diagnosis was made, the patient went on to definitive surgical resection.DiscussionThe differential diagnosis of DTs is broad, and the diagnosis is often delayed due to nonspecific presentations. Immunohistochemistry is crucial in the accurate histological diagnosis, which guides treatment. Chemotherapy and radiation have a role in the management of both primary and recurrent lesions, but surgical resection remains the cornerstone of treatment.ConclusionDTs present a clinical challenge in their diagnosis and management, and despite providing standard medical and surgical treatment, recurrence rates are high and continued surveillance is crucial.