Desmoid abdominal tumour - A clinical case report and brief literature review

Abstract

Desmoid tumours are unique mesenchymal neoplasm. They are able to spread to proximal tissues but tend not to metastasize. Our case presents a 66-year-old female referred for evaluation of the prominent, palpable mass located into the left abdomen. Imaging studies revealed a tumour up to 22 cm, extending below the diaphragm to the retroperitoneal and intra-abdominal cavity. Contrast enhanced ultrasound showed strong inhomogeneous arterial hyper-enhancement followed by persistent enhancement in a venous phase. Histology obtained with tru-cut needle biopsy established desmoid tumour, with overall proliferating activity (Ki-67 expression) of 20%. The lesion had been identified as sporadic and 'unresectable'. During the patient's follow-up a slow but continuous elevation of serum creatinine was registered eventually led to anuria, requiring emergent haemodialysis. The non-obstructing nephropathy is an unusual complication of the disease course, therefore we briefly reviewed the published data on abdominal desmoid tumours and critically analysed the relation with kidney injury.