title: Multiple desmoid tumors in a patient with Gardner's syndrome - Report of a case.
abstract: BACKGROUND
  Desmoid tumor (DT) is a common manifestation of Gardner's Syndrome (GS), although it is a rare condition in the general population. DT in patients with GS is usually located in the abdominal wall and/or intra-abdominal cavity.
  
  
  METHODS
  We report a case of a 32 years-old female patient with familial adenomatous polyposis (FAP), who was already submitted to total colectomy and developed multiple DT, located in the abdominal wall and in the left breast. The patient underwent several surgical procedures, with a multidisciplinary team of surgeons. Wide surgical resections of the left breast and the abdominal wall tumors were performed in separate steps. Polypropylene mesh reconstruction and muscle flaps were needed to cover the defects of the thoracic and abdominal walls. After partial necrosis of the adipose-cutaneous flap in the abdomen that required a new skin graft, she had a satisfactory outcome with complete healing of the surgical incisions.
  
  
  CONCLUSIONS
  DT is frequent in GS, however, breast localization is very rare, with few cases reported in the literature. Recurrence of DT is not negligible, even after a wide surgical resection. GS patients must be followed up closely, and clinical examination, associated with imaging studies, should be performed to detect any signs of tumor.
  
  
  CONCLUSIONS
  DT represents one of the most significant causes of the morbidity and mortality that affects FAP patients following colectomy. In general, the surgical procedures to excise DT are highly complex, requiring a multidisciplinary team.
authors.affiliation: Coloproctology Unit, Department of Surgery, University of Campinas, UNICAMP, Campinas, Sao Paulo, Brazil.
authors.forename: Lílian Vital
authors.initials: LV
authors.lastname: Pinheiro
authors.affiliation: Coloproctology Unit, Department of Surgery, University of Campinas, UNICAMP, Campinas, Sao Paulo, Brazil.
authors.forename: João José
authors.initials: JJ
authors.lastname: Fagundes
authors.affiliation: Coloproctology Unit, Department of Surgery, University of Campinas, UNICAMP, Campinas, Sao Paulo, Brazil.
authors.forename: Cláudio Saddy Rodrigues
authors.initials: CS
authors.lastname: Coy
authors.affiliation: Mastology Unit, Department of Gynecology, University of Campinas, UNICAMP, Campinas, Sao Paulo, Brazil.
authors.forename: Cesar
authors.initials: C
authors.lastname: Cabello
authors.affiliation: Toracic Surgery Unit, Department of Surgery, University of Campinas, UNICAMP, Campinas, Sao Paulo, Brazil.
authors.forename: Ivan
authors.initials: I
authors.lastname: Toro
authors.affiliation: Plastic Surgery Unit, Department of Surgery, University of Campinas, UNICAMP, Campinas, Sao Paulo, Brazil.
authors.forename: Marcelo
authors.initials: M
authors.lastname: Michellino
authors.affiliation: Plastic Surgery Unit, Department of Surgery, University of Campinas, UNICAMP, Campinas, Sao Paulo, Brazil.
authors.forename: Paulo Henrique
authors.initials: PH
authors.lastname: Fachina
authors.affiliation: University of Chicago Medical Center, Chicago, IL, United States.
authors.forename: Marc
authors.initials: M
authors.lastname: Ward
authors.affiliation: Coloproctology Unit, Department of Surgery, University of Campinas, UNICAMP, Campinas, Sao Paulo, Brazil. Electronic address: rafranco.unicamp@gmail.com.
authors.forename: Raquel Franco
authors.initials: RF
authors.lastname: Leal
authors.affiliation: Coloproctology Unit, Department of Surgery, University of Campinas, UNICAMP, Campinas, Sao Paulo, Brazil.
authors.forename: Maria de Lourdes Setsuko
authors.initials: Mde L
authors.lastname: Ayrizono
keywords: Desmoid tumor; Familial adenomatous polyposis; Gardner's syndrome; Surgical approach