Zouaghi Asma, Hafsi Montacer, Maroua Othman, Khouloud Marzouk, Chaouech A, Haifa Bouchahda
Department of Obstetrics and Gynecology, Tahar Sfar University Hospital, 5111 Mahdia, Tunisia.
Department of Obstetrics and Gynecology, Tahar Sfar University Hospital, 5111 Mahdia, Tunisia.
Int J Surg Case Rep. 2025 Feb;127:110897. doi: 10.1016/j.ijscr.2025.110897. Epub 2025 Jan 15.
Desmoid tumours typically arise in the abdomen and extremities. They are rare, originating from mesenchymal cells, with intra-abdominal desmoid tumours (DT) being even less common. While non-malignant and non-metastatic, they can be locally invasive, often necessitating surgical intervention for complete resection.
We present the case of a 26-year-old woman referred to our emergency department with pelvic pain three months after cesarean delivery. Abdominal computed tomography revealed a 7 cm retro-uterine mass extending to the right colon, appendix, and cecum. Although MRI suggested an intra-mesenteric benign tumour, a definitive diagnosis was not established. Surgical excision was performed for both diagnostic and therapeutic purposes, revealing a 5.5 cm desmoid tumour infiltrating adipose and muscular tissue of the last ileal loop, with negative resection margins. Postoperative recovery was uneventful, and the patient is under CT surveillance.
Intra-abdominal DTs are exceedingly rare and can present with a spectrum of symptoms. Imaging findings may mimic other conditions, making diagnosis challenging. Surgical expertise is crucial for optimal management, with complete resection being the primary therapeutic approach.
In conclusion, intra-abdominal desmoid tumours are rare entities that pose diagnostic and therapeutic challenges. Surgeons experienced in handling such cases are essential for achieving favourable outcomes. Continued surveillance is necessary due to the potential for recurrence.
硬纤维瘤通常发生于腹部和四肢。它们较为罕见，起源于间充质细胞，腹内硬纤维瘤（DT）则更为少见。虽然其为非恶性且不发生转移，但具有局部侵袭性，常常需要手术干预以实现完整切除。
我们报告一例26岁女性，剖宫产术后三个月因盆腔疼痛转诊至我院急诊科。腹部计算机断层扫描显示子宫后方有一个7厘米的肿块，延伸至右结肠、阑尾和盲肠。尽管磁共振成像提示为肠系膜内良性肿瘤，但未明确诊断。为了诊断和治疗目的进行了手术切除，结果显示为一个5.5厘米的硬纤维瘤，浸润末段回肠袢的脂肪和肌肉组织，切缘阴性。术后恢复顺利，患者接受CT监测。
腹内硬纤维瘤极其罕见，可表现出一系列症状。影像学表现可能与其他疾病相似，导致诊断具有挑战性。手术专业知识对于最佳治疗至关重要，完整切除是主要的治疗方法。
总之，腹内硬纤维瘤是罕见的疾病，带来诊断和治疗挑战。处理此类病例经验丰富的外科医生对于取得良好预后至关重要。由于存在复发的可能性，持续监测是必要的。
