Desmoid tumour (aggressive fibromatosis) of the colon mimics malignancy on dual time-point 18F-FDG PET/CT imaging

Annotating the Role of 18F-FDG PET/CT in Fibromatoses: A Benign Masquerader of Malignancies-Is It Really an Advantageous Tool?

Fibromatoses are a heterogeneous group of benign proliferating fibroblasts and myofibroblasts which have a high predilection for recurrence and local invasion, especially deep fibromatoses or desmoid fibromatosis. 18F-FDG PET/CT, the workhorse of oncological imaging in nuclear medicine, can be employed to figure out the nature and aggressiveness of the lesions and various sites of involvement and to monitor treatment response to systemic therapies like tyrosine kinase inhibitors in case of deep or desmoid fibromatoses which is shown in the current research work.

68Ga-FAPI-04 PET/CT Imaging of Mesenteric Aggressive Fibromatosis

ABSTRACT

Aggressive fibromatosis is a relatively rare disease. We describe 68Ga-FAPI-04 PET/CT findings in a case of histologically proved mesenteric aggressive fibromatosis. 68Ga-FAPI-04 PET/CT revealed a mass in the mesentery with increased FAPI activity. This case indicates that FAPI PET may be useful for evaluation of aggressive fibromatosis.

Mesenteric desmoid tumor after robot-assisted laparoscopic cystectomy with bladder replacement: a case report

Desmoid tumors are a very rare disease associated with familial adenomatous polyposis, surgical trauma and hormonal factors. Surgical trauma is a critical trigger for sporadic desmoid tumors. Tumor development has been reported, and laparoscopic surgery has become more widely performed than the conventional open surgery. However, a few cases of desmoid tumors have developed after robot-assisted surgery. When desmoid tumors develop after cancer surgery, they are often difficult to distinguish from cancer recurrence. This differentiation is important for patients with bladder cancer because it helps determine the treatment plan. However, very few cases of mesenteric desmoid tumors after cystectomy for bladder cancer have been reported. Herein, we present a case of desmoid tumor that developed following robot-assisted laparoscopic cystectomy for bladder cancer. The tumor was resected via minilaparotomy with laparoscopic assistance for diagnostic treatment.

Aggressive fibromatosis of the right colon mimicking a gastrointestinal stromal tumour: a case report

Aggressive fibromatosis is a rare type of intra-abdominal desmoid tumour that usually involves the small bowel mesentery. It is a locally-invasive lesion, with a high rate of recurrence, but without metastatic potential. Aggressive fibromatosis is seen more often in young female patients. This case report presents the radiological, intraoperative and histopathological findings from a 37-year-old female patient that presented with epigastric pain and a palpable mass in the right hemiabdomen. Histological and immunohistochemical examinations of the resected tumour, including positive staining for beta-catenin, confirmed a postoperative diagnosis of desmoid type fibromatosis. This specific case showed that desmoid type fibromatosis of the colon can mimic gastrointestinal stromal tumours (GIST) based on its clinical presentation, computed tomography and magnetic resonance imaging findings. Differential diagnosis between desmoid type fibromatosis and GIST is clinically very important due to the different treatments and follow-up protocols that are implemented for these lesions.

Not all abdominal masses after colorectal cancer surgery are malignant: intra-abdominal fibromatosis masquerading as recurrence

AIM

Intra-abdominal fibromatosis is an unusual mesenchymal tumour that can be locally aggressive without any metastatic potential. Fibromatosis may simulate cancer recurrence on imaging surveillance for colorectal cancer follow-up. The optimal treatment of recurrent peritoneal malignancy is cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC). Confirmatory biopsy of lesions suspicious for colorectal cancer recurrence may not be feasible, thereby rendering surgery the safest option. Our aim was to determine the incidence of fibromatosis in a cohort of patients undergoing CRS and HIPEC for suspected colorectal cancer recurrence.

METHODS

One hundred and seventy-one CRS and HIPEC cases were performed at our Peritoneal Malignancy Institute between February 2007 and October 2018 for colorectal peritoneal metastases and were included in a prospectively maintained database.

RESULTS

A total of 49 (29%) of 171 cases were performed for primary colorectal cancer with peritoneal metastases, whereas 122 (71%) of 171 cases were performed for suspected colorectal cancer recurrence detected on surveillance imaging after primary colorectal cancer resection. On histological analysis of the resected specimen, five (4.1%) of 122 cases undergoing CRS and HIPEC for colorectal recurrence had fibromatosis.

CONCLUSION

Fibromatosis can masquerade as colorectal cancer recurrence. In this series it occurred with an incidence of 4.1% among a cohort of patients undergoing CRS and HIPEC for probable recurrence. Surgical resection may be the only option to confirm the diagnosis and rule out malignancy.

Abdominal Wall Desmoid Fibromatosis Mimics Sarcoma With Intense FDG Uptake on FDG PET/CT

We present the case of an abdominal wall soft tissue mass with intense FDG uptake in a 61-year-old man with unintentional weight loss. The appearance of this mass and high focal FDG uptake mimics high-grade sarcoma on (18)F-FDG PET/CT. However, the final excisional histopathological diagnosis was desmoid fibromatosis.

Primary gastrointestinal non-Hodgkin's lymphoma: Analysis of 33 cases

AIM: To investigate the diagnosis and surgical treatment of primary gastrointestinal non-Hodgkin's lymphoma (PGINHL).

METHODS: The clinical data for 33 patients with PGINHL were retrospectively reviewed.

RESULTS: The tumor was mainly located in the stomach (n = 16), small intestine (n = 9), appendix (n = 1) or the colon (n = 7). All cases were pathologically confirmed to have non-Hodgkin's lymphoma. All the patients were treated surgically, containing radical excision in 26 cases, palliative resection in 4 cases, and intestinal short circuit anastomosis and biopsy in 3 cases. There were 2 deaths during the perioperative period. Twenty-two patients were followed and the 1-year survival rate was 85%.

CONCLUSION: The lack of specific clinical manifestations in PGINHL easily leads to misdiagnosis. When the diagnosis is not clear or the patient have surgical indications, surgery should be performed as soon as possible.