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Austin Surg Case Rep. 2023; 8(1): 1057.
Rare Presentation of a Large Desmoid Tumor after Surgery for Meckel’s Diverticulum
Olatz Ocerin Alganza¹*; Christian Pérez González²; María Nagore Arana de la Torre²; José María García González²
¹Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Cruces, Instituto de Investigación Sanitaria BioCruces, Barakaldo, Bizkaia, Spain
²Unidad de Cirugía Colorrectal, Hospital Universitario Cruces, Barakaldo, Bizkaia, Spain
*Corresponding author: Olatz Ocerin Alganza Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Cruces, Instituto de Investigación Sanitaria BioCruces, Barakaldo, Bizkaia, Spain. Email: olatz.ocerinalganza@osakidetza.eus
Received: June 27, 2023 Accepted: July 26, 2023 Published: August 02, 2023
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The patient is a 54-year-old male with no personal history of interest and only one previous surgery for ileal resection and mechanical anastomosis 3 years earlier due to a complicated Meckel’s diverticulum. Presently, he came to the Emergency Department with abdominal discomfort and distension over the past 3 months. Physical examination detected a mass in the right flank, and CT revealed a large exophytic mass measuring about 18_15 cm originating at the terminal ileum (Figure 1). We conducted en bloc excision of the tumor as well as 30 cm of the terminal ileum that were encompassed by it (Figure 2), followed by appendectomy and ileocolic anastomosis. The pathology report described a 17-cm desmoid fibromatosis with free resection margins and beta-catenin positivity.
Figure 1:
Figure 2:
Although the etiology is unknown, up to 30% of abdominal desmoid tumors are associated with a history of trauma injury or surgery due to impaired healing or fibroproliferative disorders of the mesenchymal tissue. Therein lays the importance of diagnostic suspicion. Furthermore, despite being mostly asymptomatic, it is important to rule out Familial Adenomatous Polyposis as a concomitant pathology, which is present in 5%–15% of cases.