A Case of Resectable Intra-abdominal Desmoid Tumor after Resection of Ascending Colon Cancer

Abstract

Intraabdominal desmoid tumor and cancer recurrence may be difficult to differentiate following intraabdominal cancer surgery. A 70-year-old man being followed up after laparoscopic-assisted ascending colon cancer surgery was indicated in computed tomography (CT) and magnetic resonance imaging (MRI) findings to have recurrent cancer suggested by a tumor in the ventral duodenum adjacent to the previous surgical scar and vascular clip. Positron emission tomography as (PET) CT, however, did not indicate cancer recurrence. Surgery for resecting the tumor together with part of the duodenal and superior mesenteric vein wall 1.5 years after the previous operation showed an isolated 4×4×4 cm hard elastic tumor with a smooth surface and a solid whitish cut surface. Histopathological findings indicated an intraabdominal desmoid tumor originating in the jejunal mesenterium and invading the superior mesenteric vein wall and muscular layer of the duodenum. No signs of recurrence were seen in followup 6 months after surgery. Although, 20 cases of intraabdominal desmoid tumor without familial adenomatous polyposis after intraabdominal surgery have been reported in the Japanese literature, our case would be the first of intraabdominal desmoid tumor without familial adenomatous polyposis after laparoscopic surgery. PET-CT thus proved very useful in differentiating between intraabdominal desmoid tumor and cancer recurrence after intraabdominal cancer surgery.