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Pathak P, Wondimu B, Jalilianhasanpour R, Pooyan A, Matesan MC, Mansoori B. Skin Malignancies: Imaging Review with Radiologic-Histopathologic Correlation. Radiographics 2023; 43:e230093. [PMID: 38032822 DOI: 10.1148/rg.230093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
Skin malignancies are commonly encountered as primary or incidental findings. Neoplasms that affect the skin include primary (basal cell carcinoma, squamous cell carcinoma, melanoma, and Merkel cell carcinoma) and secondary (mesenchymal neoplasms, lymphoma, and metastases) tumors. Imaging provides valuable anatomic information (tumor size, depth of involvement, presence of distant metastasis, and data for guiding biopsy) and functional information (metabolic activity and sentinel node mapping data). This information, in addition to biopsy results, improves the histopathologic characterization of tumors and treatment planning. Various histopathologic types of the same entity exhibit different biologic behavior and have different imaging features. Familiarity with the multimodality imaging features, histopathologic characteristics, and various modes of dissemination (direct invasion; perineural, lymphatic, and hematogenous spread) of the most common skin malignancies helps radiologists narrow the differential diagnosis in clinical practice. ©RSNA, 2023 Supplemental material is available for this article. Quiz questions for this article are available through the Online Learning Center.
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Affiliation(s)
- Priya Pathak
- From the Department of Radiology, Divisions of Abdominal Imaging and Nuclear Medicine, University of Minnesota (M-Health), 420 Delaware St SE, Minneapolis, MN 55455 (P.P.); and the Department of Pathology (B.W.); Department of Radiology (R.J., A.P.), Divisions of Nuclear Medicine (M.C.M.) and Abdominal Imaging (B.M.), University of Washington, Seattle, WA
| | - Bitania Wondimu
- From the Department of Radiology, Divisions of Abdominal Imaging and Nuclear Medicine, University of Minnesota (M-Health), 420 Delaware St SE, Minneapolis, MN 55455 (P.P.); and the Department of Pathology (B.W.); Department of Radiology (R.J., A.P.), Divisions of Nuclear Medicine (M.C.M.) and Abdominal Imaging (B.M.), University of Washington, Seattle, WA
| | - Rozita Jalilianhasanpour
- From the Department of Radiology, Divisions of Abdominal Imaging and Nuclear Medicine, University of Minnesota (M-Health), 420 Delaware St SE, Minneapolis, MN 55455 (P.P.); and the Department of Pathology (B.W.); Department of Radiology (R.J., A.P.), Divisions of Nuclear Medicine (M.C.M.) and Abdominal Imaging (B.M.), University of Washington, Seattle, WA
| | - Atefe Pooyan
- From the Department of Radiology, Divisions of Abdominal Imaging and Nuclear Medicine, University of Minnesota (M-Health), 420 Delaware St SE, Minneapolis, MN 55455 (P.P.); and the Department of Pathology (B.W.); Department of Radiology (R.J., A.P.), Divisions of Nuclear Medicine (M.C.M.) and Abdominal Imaging (B.M.), University of Washington, Seattle, WA
| | - Manuela C Matesan
- From the Department of Radiology, Divisions of Abdominal Imaging and Nuclear Medicine, University of Minnesota (M-Health), 420 Delaware St SE, Minneapolis, MN 55455 (P.P.); and the Department of Pathology (B.W.); Department of Radiology (R.J., A.P.), Divisions of Nuclear Medicine (M.C.M.) and Abdominal Imaging (B.M.), University of Washington, Seattle, WA
| | - Bahar Mansoori
- From the Department of Radiology, Divisions of Abdominal Imaging and Nuclear Medicine, University of Minnesota (M-Health), 420 Delaware St SE, Minneapolis, MN 55455 (P.P.); and the Department of Pathology (B.W.); Department of Radiology (R.J., A.P.), Divisions of Nuclear Medicine (M.C.M.) and Abdominal Imaging (B.M.), University of Washington, Seattle, WA
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Dhivakar S, Huda F, Singh SK, Kumar A, Das A, Acharya P. Giant anterior abdominal wall desmoid tumor successfully managed with abdominal wall reconstruction. J Family Med Prim Care 2023; 12:1716-1719. [PMID: 37767415 PMCID: PMC10521831 DOI: 10.4103/jfmpc.jfmpc_379_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 06/14/2023] [Accepted: 06/22/2023] [Indexed: 09/29/2023] Open
Abstract
Anterior abdominal wall fibromatosis is a benign soft tissue tumor that is rare, but fast-growing with minimal chances of malignant change. We report a young female with a large abdominal swelling which on evaluation was provisionally diagnosed as anterior abdominal wall fibromatosis on imaging and confirmed by histopathology. She was successfully managed with resection of the tumor with a challenging abdominal wall reconstruction with bilateral inferiorly based external oblique muscle flap followed by a mesh repair. Though rare, these tumors are difficult to miss. The importance of this case report is that it describes the methods of multimodal management of a patient with surgery, reconstruction, and adjuvant therapy leading to better patient outcomes.
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Affiliation(s)
- S Dhivakar
- Department of General Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Farhanul Huda
- Department of General Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sudhir K. Singh
- Department of General Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Arvind Kumar
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Asish Das
- Department of General Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Preeti Acharya
- Department of General Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Retroperitoneal desmoid tumor in a patient with familial adenomatous polyposis: A case report. Radiol Case Rep 2022; 17:2910-2914. [PMID: 35755096 PMCID: PMC9218292 DOI: 10.1016/j.radcr.2022.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 04/30/2022] [Accepted: 05/05/2022] [Indexed: 11/22/2022] Open
Abstract
Desmoid tumors are benign fibroblastic neoplasms, with locally invasive features and a tendency of recurrence. They are considered an aggressive non-metastatic fibromatosis. The retroperitoneal location is extremely rare. Their exact mechanism of occurrence is still controversial, but could be related to a genetic predisposition, hormonal factors or traumatic factors, including surgery. This entity faces management difficulties due to its rarity, the variable circumstances of its discovery, and the non-specific clinical manifestations. Their sensitivity to chemotherapy and radiotherapy is limited and surgery remains the only curative treatment in symptomatic cases, however observational waiting could consist the most appropriate management in selected asymptomatic patients, moreover it could avoid unnecessary morbidity from surgery or radiotherapy, which makes the management of this condition a multidisciplinary decision and should be adapted to fit the patients individually. We report a case of a retroperitoneal desmoid tumor in a 31-year-old woman with a history of familial adenomatous polyposis, through which we will discuss this extremely rare neoplastic entity.
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Njoku OC, Umezurike CC. Giant desmoid tumour mimicking recurrent uterine myoma in a nulliparous young Nigerian: a case report. J Med Case Rep 2022; 16:319. [PMID: 36028896 PMCID: PMC9419363 DOI: 10.1186/s13256-022-03558-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 08/03/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND 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. CASE PRESENTATION 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. CONCLUSIONS 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.
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Affiliation(s)
| | - Chisara Cyprian Umezurike
- Present Address: Kahabiri Specialist Hospital, Aba, Abia State Nigeria
- Nigerian Christian Hospital, Aba, Nigeria
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Draghi F, Cocco G, Richelmi FM, Schiavone C. Abdominal wall sonography: a pictorial review. J Ultrasound 2020; 23:265-278. [PMID: 32125676 DOI: 10.1007/s40477-020-00435-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 02/13/2020] [Indexed: 02/07/2023] Open
Abstract
The anterior abdominal wall, which is composed of three layers (skin and adipose tissues; the myofascial layer; and the deep layer, consisting of the transversalis fascia, preperitoneal fat, and the parietal peritoneum), has many functions: containment, support and protection for the intraperitoneal contents, and involvement in movement and breathing. While hernias are often encountered and well reviewed in the literature, the other abdominal wall pathologies are less commonly described. In this pictorial review, we briefly discuss the normal anatomy of the anterior abdominal wall, describe the normal ultrasonographic anatomy, and present a wide range of pathologic abnormalities beyond hernias. Sonography emerges as the diagnostic imaging of first choice for assessing abdominal wall disorders, thus representing a valuable tool for ensuring appropriate management and limiting functional impairment.
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Affiliation(s)
- Ferdinando Draghi
- Radiology Institute, IRCCS Policlinico San Matteo Foundation, University of Pavia, Viale Camillo Golgi 19, 27100, Pavia, Italy
| | - Giulio Cocco
- Unit of Ultrasound in Internal Medicine, Department of Medicine and Aging Sciences, University of Chieti G d'Annunzio, Via dei Vestini 31, 66100, Chieti, Italy.
| | - Filippo Maria Richelmi
- Radiology Institute, IRCCS Policlinico San Matteo Foundation, University of Pavia, Viale Camillo Golgi 19, 27100, Pavia, Italy
| | - Cosima Schiavone
- Unit of Ultrasound in Internal Medicine, Department of Medicine and Aging Sciences, University of Chieti G d'Annunzio, Via dei Vestini 31, 66100, Chieti, Italy
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Li M, Zhang L, Xu XJ, Shi Z, Zhao XM. CT and MRI features of tumors and tumor-like lesions in the abdominal wall. Quant Imaging Med Surg 2019; 9:1820-1839. [PMID: 31867236 DOI: 10.21037/qims.2019.09.03] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Masses involving the abdominal wall are common in clinical practice and have many etiologies, including tumors and tumor-like lesions. Abdominal wall tumors include primary and secondary tumors, the former of which constitute a heterogeneous group of soft tissue tumors with their own unique spectrum. Tumor-like lesions, such as hernias, are more common and must be distinguished from true tumors. Medical imaging is valuable for discovering, diagnosing, and evaluating the extent of abdominal wall masses. With the increasing application of computed tomography (CT) and magnetic resonance imaging (MRI), determining a diagnosis or narrowing the differential diagnosis is often possible, thus facilitating effective management. In this article, we comprehensively review the spectrum of common abdominal wall masses and present the CT and MRI features of typical cases in our hospital. A systematic stepwise diagnostic approach is also proposed for clinical practice.
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Affiliation(s)
- Meng Li
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Li Zhang
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Xiao-Juan Xu
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Zhuo Shi
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Xin-Ming Zhao
- Department of Diagnostic Radiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
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Ascari F, Segattini S, Varoli M, Beghi M, Muratori S, Scotto B, Gasperoni M. Abdominal wall reconstruction for desmoid tumour surgery: Case report. Int J Surg Case Rep 2019; 64:6-9. [PMID: 31586888 PMCID: PMC6796622 DOI: 10.1016/j.ijscr.2019.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 08/21/2019] [Accepted: 09/10/2019] [Indexed: 12/28/2022] Open
Abstract
Desmoid tumours are rare benign neoplasms with local invasion and recurrence. A margin-free excision may be challenging for the surgeon. If necessary, abdominal wall reconstruction can be required for rectus abdominis muscle tumours. A multidisciplinary approach is necessary approaching this rare disease. Introduction Desmoid tumours are rare benign neoplasms with strong tendency to local invasion and recurrence. They usually rise from muscles and aponeurosis and could be challenging for medical treatment. We here report the case of a patient requiring the excision of part of the abdominal rectus muscle and an abdominal wall reconstruction. Presentation of case A 38 years old women referred to our institution complaining of a painful lump in the anterior abdominal wall. She underwent ultrasonography (US), magnetic resonance imaging (MRI) and a computed tomography (CT) biopsy who showed the presence of a desmoid tumour arising in the right abdominal rectus muscle. She underwent surgical excision of the mass and an abdominal wall reconstruction according to the posterior component separation technique, with a large polypropylene mesh reinforcement. The post-operative period was uneventful and at 6 months she shows no clinical nor radiological recurrence. Discussion Desmoid tumours are rare neoplasms rising in many anatomical spaces and requiring challenging decisions. A radical resection with free margins remains the principal determinant of outcome. Non-surgical approaches and adjuvant therapy may be useful for patients with unresectable lesions. Conclusion The optimal treatment strategy for desmoid tumours still remains unclear. A multidisciplinary approach is always the best strategy to establish the correct treatment.
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Affiliation(s)
- Francesca Ascari
- General Surgery Unit, "Bernardino Ramazzini" Hospital, Via Guido Molinari 2, 41012, Carpi, MO, Italy
| | - Silvia Segattini
- General Surgery Unit, "Bernardino Ramazzini" Hospital, Via Guido Molinari 2, 41012, Carpi, MO, Italy
| | - Michele Varoli
- General Surgery Unit, "Bernardino Ramazzini" Hospital, Via Guido Molinari 2, 41012, Carpi, MO, Italy
| | - Massimo Beghi
- General Surgery Unit, "Bernardino Ramazzini" Hospital, Via Guido Molinari 2, 41012, Carpi, MO, Italy
| | - Simone Muratori
- General Surgery Unit, "Bernardino Ramazzini" Hospital, Via Guido Molinari 2, 41012, Carpi, MO, Italy
| | - Bruno Scotto
- General Surgery Unit, "Bernardino Ramazzini" Hospital, Via Guido Molinari 2, 41012, Carpi, MO, Italy.
| | - Marco Gasperoni
- General Surgery Unit, "Bernardino Ramazzini" Hospital, Via Guido Molinari 2, 41012, Carpi, MO, Italy
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8
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Muneer M, Badran S, Zahid R, Abdelmageed A, AlDulaimi MM. Recurrent Desmoid Tumor with Intra-Abdominal Extension After Abdominoplasty: A Rare Presentation. AMERICAN JOURNAL OF CASE REPORTS 2019; 20:953-956. [PMID: 31270310 PMCID: PMC6621933 DOI: 10.12659/ajcr.916227] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Desmoid tumors are fibrous neoplasms that originate from the musculoaponeurotic structures in the body. Abdominal wall desmoid tumors are rare, but they can be locally aggressive, with high incidence of recurrence. These tumors are more common in young, fertile women. They frequently occur during or after pregnancy. CASE REPORT We present the case of a 63-year-old post-menopausal woman with a desmoid tumor of the anterior abdominal wall. She had no relevant family history. During abdominoplasty, an incidental mass was excised and biopsied, and was identified as a desmoid tumor with free margins. One year later, the patient presented with vague abdominal discomfort and feeling of heaviness. An incision was made through the previous abdominoplasty scar to maintain the aesthetic outcome. A large mass, arising from the abdominal wall and extending intra-abdominally, was excised and was determined to be a recurrent desmoid tumor. CONCLUSIONS Recurrent anterior abdominal wall desmoid tumors in post-menopausal women are rare and locally aggressive, with a high risk of recurrence. During abdominal wall repair in abdominoplasty, desmoid tumor filaments might seed deep intra-abdominally. Therefore, it is necessary to take adequate safe margins before abdominal wall repair. Post-operatively, surgeons should keep a high index of suspicion for tumor recurrence.
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Affiliation(s)
- Mohammed Muneer
- Department of Plastic Surgery, Hamad Medical Corporation, Doha, Qatar.,Department of Surgery, Weill Cornel Medical College, Doha, Qatar
| | - Saif Badran
- Department of Plastic Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Rehan Zahid
- Department of Plastic Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Amal Abdelmageed
- Department of Health and Life Sciences, Hamad bin Khalifa University, Doha, Qatar
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Chan ACK, Chiu JHF, Chan YHY. Parasitic leiomyoma in the anterior abdominal wall. ANZ J Surg 2019; 90:E52-E53. [PMID: 31069940 DOI: 10.1111/ans.15220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 02/06/2019] [Accepted: 03/09/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Angus C K Chan
- Department of General Surgery, Kwong Wah Hospital, Hong Kong, China
| | | | - Yolanda H Y Chan
- Department of General Surgery, Kwong Wah Hospital, Hong Kong, China
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10
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Lin CH, Chang TJ, Hou MM, AbdelRahman M, Wang CW, Wang LJ, Kao D, Hsu SC, Kwon SH, Huang SY, Chang JC. How to differentiate abdominal wall leiomyomas from desmoid tumors? FORMOSAN JOURNAL OF SURGERY 2019. [DOI: 10.4103/fjs.fjs_115_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Awe OO, Eluehike S. Desmoid Fibromatosis of the Lower Abdominal Wall in Irrua Nigeria. Niger J Surg 2018; 24:52-55. [PMID: 29643736 PMCID: PMC5883852 DOI: 10.4103/njs.njs_8_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Desmoid fibromatosis (desmoid tumors) is rare tumors. It can occur as intra-abdominal, extraabdominal, or abdominal wall tumor depending on the site. The abdominal wall type is usually sporadic, but few have been associated with familial adenomatous polyposis. They are commonly seen in young females who are pregnant with a history of the previous cesarean section scar or within the 1st year of the last childbirth. There is an association between this tumor, presence of estrogen receptors, and abdominal trauma. We present a 29-year-old Nigerian woman with fungating lower abdominal wall tumor. This tumor is rare, a high index of suspicion will be very important in making the diagnosis.
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Affiliation(s)
- Oluwafemi Olasupo Awe
- Department of Surgery, Irrua Specialist Teaching Hospital, Ekpoma, Edo State, Nigeria.,Department of Surgery, Faculty of Clinical Sciences, Ambrose Alli University, Ekpoma, Edo State, Nigeria
| | - Sylvester Eluehike
- Department of Radiology, Irrua Specialist Teaching Hospital, Ekpoma, Edo State, Nigeria
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12
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Park SB, Kang BS. Value of ultrasonographic evaluation for soft-tissue lesions: focus on incidentally detected lesions on CT/MRI. Jpn J Radiol 2017; 35:485-494. [PMID: 28608002 DOI: 10.1007/s11604-017-0657-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 06/04/2017] [Indexed: 12/13/2022]
Abstract
Soft-tissue lesions of the musculoskeletal system are commonly encountered in clinical practice and often manifest as palpable lesions. Moreover, the increasing use of cross-sectional imaging such as CT or MRI has resulted in the incidental detection of many soft-tissue lesions. Ultrasonography remains the primary imaging investigation for soft-tissue lesions. It has been shown to be helpful in depicting processes involving the soft-tissue lesions on cross-sectional imaging. This article describes the ultrasonographic findings of the most frequently incidentally detected benign and malignant soft-tissue lesions on cross-sectional imaging and suggests the characteristics of such diseases, focusing on the ultrasonographic features that allow accurate diagnosis. Familiarity with the clinical setting and the appearance of soft-tissue lesions on both ultrasonography and cross-sectional imaging can lead to accurate diagnosis and appropriate management of the condition.
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Affiliation(s)
- Sung Bin Park
- Department of Radiology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102, Heukseok-ro, Dongjak-gu, Seoul, 06973, Korea.
| | - Byeong Seong Kang
- Department of Radiology, Ulsan University Hospital, Ulsan University College of Medicine, Ulsan, Korea
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13
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Abstract
Desmoid tumors, aggressive fibromatosis, are neoplasms that rarely become malignant and do not metastasize. These tumors often infiltrate and destroy adjacent vital structures and organs. The exact etiology of these tumors is unknown, but there are three known factors associated with desmoid tumors: a genetic, a hormonal, and a physical factor related to trauma. As with this case, a sonogram is commonly the first diagnostic examination that is performed to determine the identity of the soft tissue tumor.
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Affiliation(s)
- Kimberly I. Stanek
- University of Colorado, Diagnostic Medical Sonography Program, Aurora, CO,
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14
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Ahn SE, Park SJ, Moon SK, Lee DH, Lim JW. Sonography of Abdominal Wall Masses and Masslike Lesions: Correlation With Computed Tomography and Magnetic Resonance Imaging. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2016; 35:189-208. [PMID: 26657747 DOI: 10.7863/ultra.15.03027] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 05/02/2015] [Indexed: 06/05/2023]
Abstract
Sonography is usually regarded as a first-line imaging modality for masses and masslike lesions in the abdominal wall. A dynamic study focusing on a painful area or palpable mass and the possibility of ultrasound-guided aspiration or biopsy are the major advantages of sonography. On the other hand, cross-sectional imaging clearly shows anatomy of the abdominal wall; thereby, it is valuable for diagnosing and evaluating the extent of diseases. Cross-sectional imaging can help differentiate neoplastic lesions from non-neoplastic lesions. This pictorial essay focuses on sonographic findings of abdominal wall lesions compared with computed tomographic and magnetic resonance imaging findings.
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Affiliation(s)
- Sung Eun Ahn
- From the Department of Radiology, Graduate School, Kyung Hee University, Seoul, Korea (S.E.A.); and Department of Radiology, Kyung Hee University Hospital, Seoul, Korea (S.J.P., S.K.M., D.H.L., J.W.L.)
| | - Seong Jin Park
- From the Department of Radiology, Graduate School, Kyung Hee University, Seoul, Korea (S.E.A.); and Department of Radiology, Kyung Hee University Hospital, Seoul, Korea (S.J.P., S.K.M., D.H.L., J.W.L.)
| | - Sung Kyoung Moon
- From the Department of Radiology, Graduate School, Kyung Hee University, Seoul, Korea (S.E.A.); and Department of Radiology, Kyung Hee University Hospital, Seoul, Korea (S.J.P., S.K.M., D.H.L., J.W.L.)
| | - Dong Ho Lee
- From the Department of Radiology, Graduate School, Kyung Hee University, Seoul, Korea (S.E.A.); and Department of Radiology, Kyung Hee University Hospital, Seoul, Korea (S.J.P., S.K.M., D.H.L., J.W.L.)
| | - Joo Won Lim
- From the Department of Radiology, Graduate School, Kyung Hee University, Seoul, Korea (S.E.A.); and Department of Radiology, Kyung Hee University Hospital, Seoul, Korea (S.J.P., S.K.M., D.H.L., J.W.L.)
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15
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de Haas RJ, Bonenkamp JJ, Flucke UE, de Rooy JWJ. Synovial sarcoma of the abdominal wall: Imaging findings and review of the literature. J Radiol Case Rep 2015; 9:24-30. [PMID: 25926925 DOI: 10.3941/jrcr.v9i2.1992] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Synovial sarcoma is the fourth most common type of soft-tissue sarcoma (following undifferentiated pleomorphic sarcoma, liposarcoma, and rhabdomyosarcoma), and should be considered a high-grade neoplasm with a high number of local recurrences and late metastases. Synovial sarcoma predominantly occurs in adolescents and young adults, and typically arises near the joints of the lower extremity. However, this tumor can also occur at uncommon sites such as the abdominal wall, which is illustrated in this article. Furthermore, we reviewed the available literatures on the clinical, pathological and radiological appearances, as well as the current knowledge concerning treatment options and prognosis.
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Affiliation(s)
- Robbert J de Haas
- Department of Radiology, Radboud university medical center, Nijmegen, The Netherlands
| | - Johannes J Bonenkamp
- Department of Surgery, Radboud university medical center, Nijmegen, The Netherlands
| | - Uta E Flucke
- Department of Pathology, Radboud university medical center, Nijmegen, The Netherlands
| | - Jacky W J de Rooy
- Department of Radiology, Radboud university medical center, Nijmegen, The Netherlands
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16
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Palladino E, Nsenda J, Siboni R, Lechner C. A giant mesenteric desmoid tumor revealed by acute pulmonary embolism due to compression of the inferior vena cava. AMERICAN JOURNAL OF CASE REPORTS 2014; 15:374-7. [PMID: 25180474 PMCID: PMC4159246 DOI: 10.12659/ajcr.891044] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Patient: Male, 69 Final Diagnosis: Mesenteric desmoid tumor Symptoms: — Medication: — Clinical Procedure: — Specialty: Surgery
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Affiliation(s)
- Elisa Palladino
- Department of General and Digestive Surgery, Chalons en Champagne Hospital, Chalons en Champagne, France
| | - Joseph Nsenda
- Department of General and Digestive Surgery, Chalons en Champagne Hopsital, Chalons en Champagne, France
| | - Renaud Siboni
- Department of General and Digestive Surgery, Chalons en Champagne Hopsital, Chalons en Champagne, France
| | - Christian Lechner
- Department of General and Digestive Surgery, Chalons en Champagne Hopsital, Chalons en Champagne, France
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Ma JH, Ma ZH, Dong XF, Yin H, Zhao YF. Abdominal wall desmoid tumors: A case report. Oncol Lett 2013; 5:1976-1978. [PMID: 23833679 PMCID: PMC3700980 DOI: 10.3892/ol.2013.1297] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Accepted: 03/25/2013] [Indexed: 11/06/2022] Open
Abstract
Desmoid tumors (DTs) are rare lesions that do not possess any metastatic potential. However, they have a strong tendency to invade locally and recur. They constitute 3% of all soft tissue tumors and 0.03% of all neoplasms. Abdominal DTs occur sporadically or are associated with certain familial syndromes, such as familial adenomatous polyposis (FAP). The single form of this neoplasm most frequently occurs in females of reproductive age and during pregnancy. A female patient with a DT of the abdominal wall who had no relevant family history was admitted to hospital. The patient, who presented with a painless mass in the left anterolateral abdomen, had no history of trauma, surgery or childbearing. According to the medical history, physical examination and CT report, the patient was diagnosed with DT. Radical resection of the affected abdominal wall musculature was performed, and the defect was replaced with a polypropylene mesh. The histological diagnosis was of DT. The patient remains in good health and complete remission without any other treatment following surgery. DTs exhibit aggressive growth and have a high rate of recurrence. Surgery is the optimal treatment, and subsequent radiotherapy may decrease the local recurrence rate. Further research into their aetiology is required combined with multicentre clinical trials of new treatments in order to improve management of this disease. This case report provides general knowledge of DT, and may be used as a guidance for diagnosis and treatment.
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Affiliation(s)
- Jin-Hui Ma
- Department of General Surgery, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning 116027, P.R. China
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Pierucci A, Teixeira P, Zimmermann V, Sirveaux F, Rios M, Verhaegue JL, Blum A. Tumours and pseudotumours of the soft tissue in adults: perspectives and current role of sonography. Diagn Interv Imaging 2013; 94:238-54. [PMID: 23317536 DOI: 10.1016/j.diii.2012.10.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Soft tissue tumours of the musculoskeletal system are reported relatively frequently. The quality of the information gained from different imaging modalities (Doppler sonography, multislice CT, MRI spectroscopy, and diffusion MRI) means that in a growing number of situations, we can envisage determining with great accuracy not only the usual information of tumour size and topography, but often the exact nature of the tissue, almost always identifying whether a lesion is aggressive or not. Of all these techniques, Doppler sonography has become the most widely used due to the striking improvements in its sensors, especially for superficial applications. Some other recent developments are: panoramic imaging, elastography (although its current contribution is still to be determined but it seems to offer promising potential), and, most importantly, specific contrast agents. These techniques have considerably refined the quality of the information obtained, and have particularly enhanced the degree of sensitivity with which lesion progression can be assessed. Ultrasonography is the very first investigation in our protocol. It is also very often used to close investigations, as it accurately guides core needle biopsy from these generally accessible lesions. The purpose of this article is to bring together updated information on the various collections of sonographic features seen in soft tissue tumours and pseudotumours and to emphasise the considerable contributions of these new technological developments, in particular contrast-enhanced sonography. The discussion will follow the World Health Organisation's anatomical pathology classifications of soft tissue tumours. We will close with a synthesis that summarises the main steps in our diagnostic process.
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Affiliation(s)
- A Pierucci
- Guilloz Imaging Department, Central Hospital, Nancy University Hospital, avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy cedex, France
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Abstract
Desmoid tumors are rare neoplasms. They occur mostly in females in their reproductive age and may present with pelvic pain and intestinal obstruction. These connective tissue neoplasms are because of uncontrolled proliferation of differentiated myofibroblasts. The cells may synthesize vast amounts of collagen fibers in response to various stimuli. We describe a case of a pelvic desmoid tumor simulating a uterine leiomyoma recurrence. We review the literature on the epidemiology and the treatment options for desmoid tumors and suggest a strong index of suspicion when a new pelvic mass arises in an adult with previous pelvic surgery. We advise a planned multidisciplinary treatment approach at the first hint of the diagnosis of desmoid tumor.
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Virmani V, Sethi V, Fasih N, Ryan J, Kielar A. The abdominal wall lumps and bumps: cross-sectional imaging spectrum. Can Assoc Radiol J 2012; 65:9-18. [PMID: 22884230 DOI: 10.1016/j.carj.2012.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2011] [Revised: 12/31/2011] [Accepted: 02/10/2012] [Indexed: 10/28/2022] Open
Abstract
This article focuses on the cross-sectional imaging spectrum of abnormalities that affect the abdominal wall, with emphasis on magnetic resonance imaging (MRI). Cross-sectional imaging is valuable for diagnosing and evaluating the extent of abdominal-wall masses. With the increasing use of MRI, it is often possible to reach a diagnosis or narrow the differential diagnosis, thereby guiding effective management. Neoplastic and non-neoplastic pathologies will be illustrated, and the distinctive imaging characteristics of these entities will be highlighted.
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Affiliation(s)
- Vivek Virmani
- The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.
| | - Vineeta Sethi
- The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
| | - Najla Fasih
- The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
| | - John Ryan
- The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
| | - Ania Kielar
- The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
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Abstract
BACKGROUND An abdominal wall desmoid tumor is a rare event, has a strong tendency for local invasion and recurrence, and usually presents as an abdominal lump. CASE A 35-year-old multiparous woman presented with a painful abdominal lump that had been slowly increasing in size. The pain was not associated with menstruation. Clinical examination, ultrasonography, and abdominal magnetic resonance imaging were performed and suggested a large, sharply defined mass measuring approximately 11 × 7.1 cm in the right anterolateral abdominal wall. There was no family history of familial adenomatous polyposis. The mass was excised and sent for histopathologic examination, which indicated abdominal wall desmoid tumor. CONCLUSION Abdominal wall desmoid tumors can be diagnostic dilemmas and should be considered in the differential diagnosis for lumps in the abdomen in women.
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Xiang JJ, Mao YQ, Cai BS, Zhong BS, You QH, Lin YW, Chen H, Shen BH, Zheng XY. Imaging of desmoid tumor located in renal hilum. Nephrology (Carlton) 2012; 17:589-90. [PMID: 22823565 DOI: 10.1111/j.1440-1797.2012.01582.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ibrahimi OA, Jim On SC, Fung MA, Eisen DB. A longstanding deep-seated nuchal tumor. Int J Dermatol 2012; 51:910-2. [PMID: 22788805 DOI: 10.1111/j.1365-4632.2011.05364.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Omar A Ibrahimi
- Department of Dermatology, University of Connecticut, Farmington, CT 06032, USA.
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Imaging features of superficial and deep fibromatoses in the adult population. Sarcoma 2012; 2012:215810. [PMID: 22966216 PMCID: PMC3395298 DOI: 10.1155/2012/215810] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2012] [Accepted: 03/30/2012] [Indexed: 12/13/2022] Open
Abstract
The fibromatoses are a group of benign fibroblastic proliferations that vary from benign to intermediate in biological behavior. This article will discuss imaging characteristics and patient demographics of the adult type superficial (fascial) and deep (musculoaponeurotic) fibromatoses. The imaging appearance of these lesions can be characteristic (particularly when using magnetic resonance imaging). Palmar fibromatosis demonstrates multiple nodular or band-like soft tissue masses arising from the proximal palmar aponeurosis and extending along the subcutaneous tissues of the finger in parallel to the flexor tendons. T1 and T2-weighted signal intensity can vary from low (higher collagen) to intermediate (higher cellularity), similar to the other fibromatoses. Plantar fibromatosis manifests as superficial lesions along the deep plantar aponeurosis, which typically blend with the adjacent plantar musculature. Linear tails of extension (“fascial tail sign”) along the aponeurosis are frequent. Extraabdominal and abdominal wall fibromatosis often appear as a heterogeneous lesion with low signal intensity bands on all pulse sequences and linear fascial extensions (“fascial tail” sign) with MR imaging. Mesenteric fibromatosis usually demonstrates a soft tissue density on CT with radiating strands projecting into the adjacent mesenteric fat. When imaging is combined with patient demographics, a diagnosis can frequently be obtained.
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Felice FD, Musio D, Caiazzo R, Dipalma B, Grapulin L, Semproni CP, Tombolini V. An unusual case of fatty liver in a patient with desmoid tumor. World J Gastroenterol 2012; 18:3173-6. [PMID: 22791954 PMCID: PMC3386332 DOI: 10.3748/wjg.v18.i24.3173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2011] [Revised: 03/02/2012] [Accepted: 05/06/2012] [Indexed: 02/06/2023] Open
Abstract
A desmoid tumor, also known as aggressive fibromatosis, is a rare benign neoplasm that arises from fascial or musculoaponeurotic tissues. It can occur in any anatomical location, most commonly the abdominal wall, shoulder girdle and retroperitoneum. The typical clinical presentation is a painless mass with a slow and progressive invasion of contiguous structures. It is associated with a high local recurrence rate after resection. Many issues regarding the optimal treatment of desmoid tumors remain controversial. Aggressive surgical resection with a wide margin (2-3 cm) remains the gold standard treatment with regard to preserving quality of life. Radiotherapy alone has been shown to be effective for the control of unresectable or recurrent lesions. Desmoid tumors tend to be locally infiltrative, therefore, the fields must be generous to prevent marginal recurrence. The radiation dose appropriate for treating desmoid tumors remains controversial. We present a 25-year-old Caucasian man with local recurrence of a desmoid tumor after repeated surgical resection, treated with radiotherapy. The patient achieved complete tumor regression at 4 mo after radiotherapy, and he is clinically free of disease at 12 mo after the end of treatment, with an acceptable quality of life. The patient developed short bowel syndrome as a complication of second surgical resection. Consequently, radiotherapy might have worsened an already present malabsorption and so led to steatohepatitis.
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Economou A, Pitta X, Andreadis E, Papapavlou L, Chrissidis T. Desmoid tumor of the abdominal wall: a case report. J Med Case Rep 2011; 5:326. [PMID: 21787413 PMCID: PMC3162920 DOI: 10.1186/1752-1947-5-326] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2010] [Accepted: 07/25/2011] [Indexed: 11/12/2022] Open
Abstract
Introduction Desmoid tumors are rare lesions without any metastatic potential but a strong tendency to invade locally and to recur. These tumors are associated with women of fertile age, especially during and after pregnancy. Case presentation The case of a desmoid tumor of the anterior abdominal wall in a 40-year-old Caucasian man with no relevant family history is presented, describing its appearance on computed tomography and ultrasonography. The patient, who presented with a painless mass in the left anterolateral abdomen, had a history of previous urgent abdominal surgery after a shotgun injury two years earlier. Radical resection of the affected abdominal wall musculature was performed, and the defect was reconstructed with polypropylene mesh. Conclusion The diagnosis of desmoid tumor should be strongly considered even in male patients with an abdominal mass and a history of previous abdominal surgery. The goal of its treatment is complete tumor excision and avoidance of the development of complications such as hernia.
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Affiliation(s)
- Athanasios Economou
- Department of Radiology, General Hospital "Agios Pavlos," Ethn, Antistaseos 161, 55134 Thessaloniki, Greece.
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Murphey MD, Ruble CM, Tyszko SM, Zbojniewicz AM, Potter BK, Miettinen M. Musculoskeletal Fibromatoses: Radiologic-Pathologic Correlation. Radiographics 2009; 29:2143-73. [DOI: 10.1148/rg.297095138] [Citation(s) in RCA: 170] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Imaging of superficial and deep fibromatosis. Radiol Med 2009; 114:1292-307. [PMID: 19789958 DOI: 10.1007/s11547-009-0458-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2008] [Accepted: 11/03/2008] [Indexed: 12/15/2022]
Abstract
The purpose of this paper was to illustrate the role of diagnostic imaging in superficial and deep fibromatosis through a review of the use of different imaging modalities, including radiography, ultrasound (US), computed tomography (CT), magnetic resonance imaging (MRI), angiography and scintigraphy. In particular, in agreement with published data, it emphasises the crucial role of MRI as the primary modality providing the information needed for management decisions, preoperative planning and follow-up of these lesions.
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Ramos-Font C, Santiago Chinchilla A, Rebollo Aguirre AC, Rodríguez Fernández A, Medina Benítez A, Llamas Elvira JM. [Desmoid tumor of the thoraco-abdominal wall characterized with 18F-fluorodeoxyglucose PET/ CT scan. Correlation with magnetic resonance and bone scintigraphy. Review of the literature]. ACTA ACUST UNITED AC 2009; 28:70-3. [PMID: 19406052 DOI: 10.1016/s0212-6982(09)70700-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Desmoid tumours are uncommon benign tumours but with aggressive behaviour, resulting from the proliferation of well-differentiated fibroblasts. Clinically, they present as a painless firm soft tissue mass. They can be solitary or multiple and have potential infiltrative capacity. When planning treatment, it is important to assess the correct tumour extent to permit curative radical surgery minimizing possible local recurrence. Different imaging techniques help to characterise these tumours. At present, magnetic resonance is the tool of choice for studying these tumours. The role of nuclear medicine techniques, such as bone scintigraphy, or more recently FDG-PET, has not been defined in the evaluation of these neoplasms. We present the case of a patient with a desmoid tumour of the abdominal-chest wall and we review the related literature.
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Affiliation(s)
- C Ramos-Font
- Servicio de Medicina Nuclear, Hospital Universitario Virgen de las Nieves, Granada, Spain.
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Wang Y, Tang J, Luo Y. Sonographic diagnosis of fibromatosis. JOURNAL OF CLINICAL ULTRASOUND : JCU 2008; 36:330-334. [PMID: 18446862 DOI: 10.1002/jcu.20483] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
PURPOSE To investigate the value of sonography in the diagnosis of fibromatosis. METHOD We retrospectively reviewed the sonographic findings, pathologic results, and other medical records of 42 patients with pathologically proven fibromatosis. The tumor's size and location were recorded. Echogenicity, margins, vascularity, and relationship with the adjacent tissue were analyzed. RESULTS A total of 42 patients with 44 lesions were included in the study. In 21 patients, the tumor was a primary tumor. In 7 of these patients, a preoperative diagnosis of fibromatosis was obtained via sonographically guided biopsy or surgical biopsy. In another 21 patients, the tumor was a recurrence (including 1 case of malignant transformation). Well-defined and regular margins were demonstrated in 26 lesions (59%), whereas poorly defined and irregular borders were seen in the other 18 lesions. On Doppler imaging, vascularity was absent in 66% (29/44) lesions, moderate in 23% (10/44), and marked in 11% (5/44). Infiltration into the adjacent skeletal muscles, cortical bone, or encasement vessels, nerves, or tendons was found in 21 (48%) lesions. CONCLUSION In patients with fibromatosis, sonography demonstrates a nonspecific hypoechoic solid mass and can guide the percutaneous needle biopsy.
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Affiliation(s)
- Yuexiang Wang
- Department of Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing 100853, China
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