[Case report: Rapidly growing abdominal wall giant desmoid tumour during pregnancy].
BACKGROUND
Desmoid tumours are one of the rarest tumours worldwide, with an estimated yearly incidence of 2-4 new cases per million people. They are soft tissue monoclonal neoplasms that originate from mesenchymal stem cells. It seems that the hormonal and immunological changes occurring during pregnancy may play a role in the severity and course of the disease.


METHODS
The case is presented on 28-year-old female in her fifth week of gestation, in whom an abdominal wall tumour was found attached to left adnexa and uterus while performing a prenatal ultrasound. The patient was followed up under clinical and ultrasonographic surveillance. When she presented with abnormal uterine activity at 38.2 weeks of gestation, she was admitted and obstetrics decided to perform a caesarean section. Tumour biopsy was taken during the procedure. Histopathology reported a desmoid fibromatosis. A contrast enhanced abdominal computed tomography scan was performed, showing a tumour of 26×20.5×18cm, with well-defined borders in contact with the uterus, left adnexa, bladder and abdominal wall, with no evidence of infiltration to adjacent structures. A laparotomy, with tumour resection, hysterectomy and left salpingo-oophorectomy, components separation techniques, polypropylene mesh insertion, and drainage was performed. The final histopathology report was desmoid fibromatosis. There is no evidence of recurrence after 6 months follow-up.


CONCLUSIONS
Desmoid tumours are locally aggressive and surgical resection with clear margins is the basis for the treatment of this disease, using radiotherapy, chemotherapy and hormone therapy as an adjunct in the treatment.
Servicio de Cirugía General, Hospital Universitario Dr. José Eleuterio González. Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México. Electronic address: jorgepalacios_@hotmail.com.
Jorge Tadeo
JT
Palacios-Zertuche
Servicio de Cirugía General, Hospital Universitario Dr. José Eleuterio González. Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México.
Servando
S
Cardona-Huerta
Servicio de Cirugía General, Hospital Universitario Dr. José Eleuterio González. Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México.
María Luisa
ML
Juárez-García
Servicio de Cirugía General, Hospital Universitario Dr. José Eleuterio González. Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México.
Everardo
E
Valdés-Flores
Servicio de Cirugía General, Hospital Universitario Dr. José Eleuterio González. Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, México.
Gerardo Enrique
GE
Muñoz-Maldonado
D034861:Abdominal Wall; D000328:Adult; D018450:Disease Progression; D005260:Female; D018221:Fibromatosis, Abdominal / Q000473:pathology*; D006801:Humans; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000473:pathology*; D013997:Time Factors
Desmoid tumour; Embarazo; Pregnancy; Rapid growth; Rápido crecimiento; Tumor desmoide