Intra-abdominal desmoid tumors mimicking gastrointestinal stromal tumors — 8 cases: A case report

Mesenteric desmoid tumor after laparoscopic resection of stage I endometrial cancer: A case report

Mesenteric desmoid tumors (DTs) are rare, and there are no specific imaging features that can aid definitive diagnosis. This article presents the case of a 61-year-old woman found to have intra-abdominal DT located in the mesentery at two-year follow-up after laparoscopy-assisted anterior resection for stage I endometrial cancer. Computed tomography (CT) indicated the presence of a solitary tumor arising from the intestinal wall or mesentery. Subsequent magnetic resonance imaging and integrated positron emission tomography/CT with 2-18F-fluoro-2-deoxy-d-glucose suggested DT rather than recurrence, but surgical resection was chosen after considering the potential risks. Surgery confirmed the diagnosis, revealing a tumor at the level of the jejunal mesentery and approximately 5 cm in diameter. The mesenteric tumor was resected, along with part of the jejunum and the greater omentum. Histopathological examination of the surgical specimens confirmed the diagnosis of DT. As mesenteric DT after laparoscopic resection of stage I endometrial cancer is rare, a high degree of suspicion is necessary for diagnosis. Given that laparoscopic surgery is increasingly used in gynecological clinical practice, gynecologists and radiologists should be aware that DT should be considered in the differential diagnosis when a mesenteric mass is detected during follow-up after a surgical procedure, including laparoscopy.

Desmoid-type fibromatosis: imaging features and course

Desmoid-type fibromatosis (DF) is a soft tissue tumor characterized by infiltrative growth and a tendency toward local recurrence, while it exhibits self-limiting behavior and shows spontaneous regression. With its unpredictable behavior, a change in treatment strategies from initial surgery to nonsurgical management has been proposed, and active surveillance is currently widely chosen as the initial treatment strategy for DF. We reviewed the imaging features of DF regarding its clinical course, focusing on regression cases, postoperative cases, and imaging changes after systemic treatment.

Large desmoid tumour of the small bowel mesentery

A 74-year-old man was being investigated for a pancreatic insulinoma when an incidental mesenteric mass measuring 2.6 cm x 2.5 cm was noticed on CT imaging. A wait-and-see approach was decided on. Thirty-nine months later, the patient presented with symptoms of abdominal obstruction. CT images revealed the mesenteric mass filled majority of the abdominal cavity and measured 29 cm x 26 cm x 16 cm. The patient underwent an open bypass gastrojejunostomy which stopped working a few weeks later due to further compression by the tumour. A debulking surgery was performed: a right hemicolectomy and small bowel resection with excision of the desmoid tumour and bypass gastrojejunostomy. The tumour measured 12.6 kg and was macroscopically visualised to have a white cut surface with a focal translucent area. Microscopic analysis revealed bland spindle cells with pale eosinophilic cytoplasm showing no cytological atypia, in keeping with a mesenteric desmoid tumour. Currently, two and a half years from the debulking surgery, the patient remains well and in remission with planned surveillance.