Rapid progression of a pregnancy-associated intra-abdominal desmoid tumor in the post-partum period: A case report.

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Rapid progression of a pregnancy-associated intra-abdominal desmoid tumor in the post-partum period: A case report.

Int J Surg Case Rep. 2016 Oct 26;29:30-33

Authors: Hanna D, Magarakis M, Twaddell WS, Alexander HR, Kesmodel SB

Abstract
INTRODUCTION: The clinical behavior of desmoid tumors can be unpredictable, particularly when they arise in the ante-partum or post-partum period. We present a case of an intra-abdominal desmoid tumor that was identified in the ante-partum period, progressed rapidly in the post-partum period, and was subsequently resected.
PRESENTATION OF CASE: The patient is a 19 year-old female who was found to have a 12cm intra-abdominal mass on a fetal assessment ultrasound. The decision was made to observe the patient and monitor the mass for growth. However, the mass rapidly grew in the post-partum period. The patient was transferred to our institution after an exploratory laparotomy revealed a large intra-abdominal mass emanating from the small bowel mesentery. The 30cm×24cm×16cm mass was successfully resected with negative margins, and the pathologic diagnosis of desmoid tumor was confirmed. The patient had an uncomplicated post-operative course and was discharged on post-operative day 6.
DISCUSSION: The majority of pregnancy-associated desmoid tumors are in the abdominal wall, arising from the rectus abdominus muscle or from previous Cesarean section scars. These tumors may spontaneously regress in the post-partum period and therefore, patients with these tumors are often observed. Close follow-up is important so that rapid tumor progression, which may lead to unresectability, can be identified and managed appropriately.
CONCLUSION: A patient with a rare case of a giant pregnancy-associated, intra-abdominal desmoid tumor that rapidly progressed in the post-partum period and was successfully treated with surgical resection with negative margins.

PMID: 27810608 [PubMed - as supplied by publisher]

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