Royal Tropical Institute, Amsterdam, Netherlands.
Kahabiri Specialist Hospital, Aba, Abia State, Nigeria.
J Med Case Rep. 2022 Aug 27;16(1):319. doi: 10.1186/s13256-022-03558-6.
Desmoid tumors are rare lesions. Although they demonstrate tumor characteristics, such as infiltrative growth and tendency towards local recurrence, they lack the ability to metastasize. To date, the cause of desmoid tumors is unknown. They can occur in both sexes, but predominant slightly in women, including nulliparous women, of reproductive age, but mostly during and after pregnancy.
A 36-year-old nulliparous Nigerian woman presented with a large desmoid tumor of the anterior abdominal wall, mimicking recurrent leiomyoma. At presentation, she had a painless abdominal mass for 1 year, which was first noticeable as a small induration that progressively increased in size. The patient had a previous surgical history of open myomectomy for symptomatic fibroids of 3 years duration, prior to presentation. Treatment comprised a complete excision of the tumor with a wide margin and partial omentectomy and the anterior abdominal wall closed in layers, though without prosthesis. The patient subsequently developed incisional hernia.
Large desmoid tumors may be misdiagnosed or mistaken for uterine leiomyoma or other abdominal or pelvic tumors. Attention should therefore be paid to detailed patient history and systematic clinical evaluation. To guard against incisional hernia associated with surgical resection of huge desmoid tumors, mesh reconstruction is recommended.
硬纤维瘤是一种罕见的病变。尽管它们具有肿瘤的特征,如浸润性生长和局部复发的倾向,但它们缺乏转移的能力。迄今为止,硬纤维瘤的病因尚不清楚。它们可以发生在两性,但略多见于女性,包括未生育的育龄妇女,但大多发生在妊娠期间和之后。
一位 36 岁的尼日利亚未婚妇女,表现为前腹壁的巨大硬纤维瘤,类似于复发性平滑肌瘤。就诊时,她有 1 年的无痛性腹部肿块病史,最初是一个小硬结,逐渐增大。患者有 3 年前因症状性子宫肌瘤接受开腹子宫肌瘤切除术的手术史。治疗包括肿瘤的完全切除,广泛的边缘切除和部分网膜切除术,前腹壁分层关闭,尽管没有使用假体。随后患者发生了切口疝。
大型硬纤维瘤可能被误诊或误诊为子宫平滑肌瘤或其他腹部或盆腔肿瘤。因此,应注意详细的患者病史和系统的临床评估。为了防止与巨大硬纤维瘤的手术切除相关的切口疝,建议使用网片重建。