Case Report
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World J Gastroenterol. Jun 28, 2012; 18(24): 3173-3176
Published online Jun 28, 2012. doi: 10.3748/wjg.v18.i24.3173
An unusual case of fatty liver in a patient with desmoid tumor
Francesca De Felice, Daniela Musio, Rossella Caiazzo, Bartolomeo Dipalma, Lavinia Grapulin, Camilla Proietti Semproni, Vincenzo Tombolini
Francesca De Felice, Daniela Musio, Rossella Caiazzo, Bartolomeo Dipalma, Lavinia Grapulin, Camilla Proietti Semproni, Vincenzo Tombolini, Department of Radiological Sciences-Oncology and Pathological Anatomy, and Department of Radiotherapy, University of Rome “La Sapienza”, 00161 Rome, Italy
Author contributions: De Felice F, Musio D wrote the article; Caiazzo R, Dipalma B, Proietti Semproni C and Grapulin L performed data acquisition; Tombolini V gave final approval of the version to be published.
Correspondence to: Francesca De Felice, MD, Department of Radiological Sciences-Oncology and Pathological Anatomy, and Department of Radiotherapy, University of Rome “La Sapienza”, Viale Regina Elena 326, 00161 Roma, Italy. brency7@hotmail.it
Telephone: +39-6-491774 Fax: +39-6-49973039
Received: November 23, 2011
Revised: March 2, 2012
Accepted: May 6, 2012
Published online: June 28, 2012
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.

Keywords: Desmoid tumor; Aggressive fibromatosis; Fatty liver