Department of Gastroenterology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China.
Medicine (Baltimore). 2021 Nov 19;100(46):e27897. doi: 10.1097/MD.0000000000027897.
Familial adenomatous polyposis (FAP) associated with desmoids tumors (DTs) complicated by abscess formation is rare. The management is not easy and the choice of the best treatment may be controversial.
A 33-year-old man was admitted to our hospital for abdominal pain, fever, chills, nausea, and vomiting. He had a family history of FAP, and history of abdominal surgery.
An abdominal enhanced chest computed tomography (CT) scan revealed a soft tissue mass in the abdominal wall and an irregular mesenteric soft tissue mass with internal fistula and intra-abdominal abscess. A CT-guided biopsy of the abdominal wall mass revealed DTs.
The patient was given oral antibiotics for 6 months, and ultimately underwent surgery.
The patient had no evidence of recurrence on follow-up at 10 months.
This case indicates that for patients with FAP who have a history of abdominal surgery and a progressively enlarging mass and abscess in the abdomen, it is necessary to consider the possibility of DTs. FAP-related DTs are rarely complicated by abscess formation. Antibiotic therapy plus surgical resection of the tumor may be effective and make good prognosis.
家族性腺瘤性息肉病（FAP）伴发的硬纤维瘤（DTs）合并脓肿形成较为罕见。其治疗并不容易，最佳治疗方案的选择可能存在争议。
一名 33 岁男性因腹痛、发热、寒战、恶心和呕吐而入院。他有 FAP 家族史和腹部手术史。
腹部增强胸部计算机断层扫描（CT）显示腹壁软组织肿块和肠系膜不规则软组织肿块，伴内瘘和腹腔脓肿。腹壁肿块的 CT 引导活检显示为 DTs。
患者接受了 6 个月的口服抗生素治疗，最终接受了手术。
患者在 10 个月的随访中无复发迹象。
该病例表明，对于有腹部手术史且腹部逐渐增大的肿块和脓肿的 FAP 患者，需要考虑 DTs 的可能性。FAP 相关的 DTs 很少合并脓肿形成。抗生素治疗联合肿瘤切除术可能有效，预后良好。
