Mucosal ischemia caused by desmoid tumors in patients with familial adenomatous polyposis: report of four cases.
OBJECTIVE
The study contained herein was undertaken to demonstrate that mesenteric desmoid tumors can cause significant symptoms other than by a mass effect and that surgery can be effective in treating these symptoms.


METHODS
The medical records of patients with intra-abdominal desmoid disease in the David G. Jagelman Inherited Colorectal Cancer Registry were reviewed. Four cases are described in which intramesenteric desmoid tumors adjacent to the bowel caused mucosal ischemia in patients with familial adenomatous polyposis.


RESULTS
In one patient with an ileorectal anastomosis, this was manifest by multiple small-bowel strictures and treated by multiple strictureplasties. The other three patients had ileal pouches and presented with bleeding and pain from mucosal ulceration. All pouches needed to be removed.


CONCLUSIONS
Intra-abdominal desmoid tumors may cause problems other than by mass effect. Patients with familial adenomatous polyposis and symptoms suggestive of desmoid disease but with no detectable mass should not be denied surgery.
Church
J M
JM
Department of Colorectal Surgery, Cleveland Clinic, Ohio, USA.
D011125:Adenomatous Polyposis Coli / Q000150:complications*; D000328:Adult; D005260:Female; D018222:Desmoid Tumors / Q000150:complications* / Q000601:surgery; D006801:Humans; D007413:Intestinal Mucosa / Q000098:blood supply* / Q000601:surgery; D007511:Ischemia / Q000209:etiology* / Q000601:surgery; D008875:Middle Aged; D016896:Treatment Outcome