Giant Abdominal Wall Desmoid Tumor with Mass Effect: A Case Report and Review of the Literature

Abstract

Desmoid tumors, or aggressive fibromatoses, are rare fibroblastic proliferations of soft tissues. Although benign from a metastatic standpoint, they possess a high potential for local invasion. Giant forms, inducing a compressive mass effect, pose complex therapeutic challenges. This case report highlights the critical decision-making process in giant abdominal wall desmoid tumors where immediate salvage surgery takes precedence over conservative active surveillance due to severe symptoms and tissue compression. We report the case of a 46-year-old female patient presenting with a large mass on the abdominal wall evolving over 6 months, causing chronic pain, functional impairment, and a significant mass effect on adjacent pelvic structures. Magnetic resonance imaging (MRI) revealed a large infiltrating tissue lesion. Biopsy and immunohistochemistry confirmed the diagnosis of aggressive fibromatosis. Given the significant mass effect, wide surgical excision with tumor-free margins was performed. The postoperative course was uneventful, with no local recurrence at the 6-month follow-up.
Conclusion: The management of giant desmoid tumors with mass effect requires a personalized, multidisciplinary approach, oscillating between monitoring, medical alternatives, and salvage surgery.