Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Sep 15, 2017; 9(9): 385-389
Published online Sep 15, 2017. doi: 10.4251/wjgo.v9.i9.385
Desmoid type fibromatosis: A case report with an unusual etiology
Syed Faisal Jafri, Obada Obaisi, Gerardo G Vergara, Joe Cates, Jaswinder Singh, Jennifer Feeback, Harathi Yandrapu
Syed Faisal Jafri, Gastroenterology, Research Medical Center, Kansas City, MO 64132, United States
Obada Obaisi, School of Medicine, University of Missouri in Kansas City, Kansas City, MO 64108, United States
Gerardo G Vergara, Pathology, Research Medical Center, Kansas City, MO 64132, United States
Joe Cates, General and Vascular Surgery, Research Medical Center, Kansas City, MO 64132, United States
Jaswinder Singh, Hematology/Oncology, Research Medical Center, Kansas City, MO 64132, United States
Jennifer Feeback, Division Director of Clinical Research, Research Medical Center, Kansas City, MO 64132, United States
Harathi Yandrapu, Internal Medicine Department of Research Medical Center and Research Department of Kansas City Veterans Affairs Medical Center, Kansas City, MO 64132, United States
Author contributions: Obaisi O prepared the manuscript and conducted the literature search; Vergara GG provided the histopathology narrative and photomicrographs; all other authors directly involved in the clinical care of the patient reviewed the manuscript and provided adequate input to finalize the manuscript.
Institutional review board statement: The application for Exemption from the IRB review and the research summary as written for the Case Report: Desmoid type fibromatosis: A case report with an unusual etiology was reviewed. It was determined the project is exempt from the IRB review by DHHS regulation 45CFR 46.101(b)(4).
Informed consent statement: The study participant provided informed written consent prior to the study.
Conflict-of-interest statement: All authors disclosed no conflicts of interest relevant to this publication.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Obada Obaisi, UMKC-Student, School of Medicine, University of Missouri in Kansas City, 2411 Holmes Street, Kansas City, MO 64108, United States. oofy3@mail.umkc.edu
Telephone: +1-217-3149489 Fax: +1-816-2763568
Received: May 17, 2016
Peer-review started: May 18, 2016
First decision: July 5, 2016
Revised: August 29, 2016
Accepted: September 7, 2016
Article in press: September 8, 2016
Published online: September 15, 2017
Processing time: 481 Days and 12.7 Hours
Abstract

Desmoid type fibromatosis (DTF) is a rare, locally invasive, non-metastasizing soft tissue tumor. We report an interesting case of DTF involving the pancreatic head of a 54-year-old woman. She presented with intermittent dysphagia and significant weight loss within a 3-mo period. Laboratory findings showed mild elevation of transaminases, significant elevation of alkaline phosphatase and direct hyperbilirubinemia, indicating obstructive jaundice. Computerized tomography of the abdomen revealed a mass in the head of the pancreas, dilated common bile duct, and dilated pancreatic duct. Endoscopic retrograde cholangiopancreatography and endoscopic ultrasound showed a large hypoechoic mass in the head of the pancreas causing extrahepatic biliary obstruction and pancreatic ductal dilation. The patient underwent a successful partial pancreatico-duodenectomy and cholecystectomy. She received no additional therapy after surgery, and liver function tests were normalized within nine days after surgery. Currently, surgical resection is the recommended first line treatment. The patient will be followed for any recurrence.

Keywords: Desmoid type fibromatosis; Desmoid tumor; Aggressive fibromatosis; Pancreas; Painless jaundice

Core tip: Desmoid type fibromatosis (DTF) is a rare, locally invasive, non-metastasizing soft tissue tumor. We report an extremely rare case of DTF in the pancreatic head with an unusual etiology. This case study is valuable for the understanding of the diagnosis and treatment of DTF of the pancreatic head.