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A giant pregnancy-associated intra-abdominal desmoid tumour: not necessarily a contraindication for subsequent pregnancy.

de Bree E, Dimitriadis E, Giannikaki E, Chryssou EG, Melissas J - World J Surg Oncol (2013)

Bottom Line: A potential aetiological role for female hormones is indicated.After a subsequent pregnancy, the patient delivered healthy twins 26 months later.Based on this case and a few others reported in the literature, subsequent pregnancy does not necessarily seem to be a risk factor for recurrent or new disease.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgical Oncology, Medical School of Crete University Hospital, Heraklion, Greece. debree@edu.uoc.gr.

ABSTRACT
Desmoid tumours are rare mesenchymal tumours, often locally invasive and characteristically associated with a high local recurrence rate after resection. A potential aetiological role for female hormones is indicated. Pregnancy-associated desmoid tumours are almost exclusively located in the abdominal wall. An essential issue is how to counsel women who have had a pregnancy-associated desmoid tumour and subsequently wish to bear a child. A considerably rare case of a patient with a resection of a giant pregnancy-associated, 33 cm in diameter, intra-abdominal desmoid tumour is presented. After a subsequent pregnancy, the patient delivered healthy twins 26 months later. Fifty-four months after treatment, there are no signs of recurrent or second desmoid tumour. Although rarely located in the abdomen, pregnancy-associated desmoid tumours should be included in the differential diagnosis of intra-abdominal tumours detected during or shortly after pregnancy. Based on this case and a few others reported in the literature, subsequent pregnancy does not necessarily seem to be a risk factor for recurrent or new disease.

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Histological findings. Microscopically the tumour was composed of bland, spindle or stellate mesenchymal cells, without obvious atypia or increased mitotic index. The cells were arranged haphazardly in a dense fibrous stroma with thick walled vessels (H&E, ×100).
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Figure 5: Histological findings. Microscopically the tumour was composed of bland, spindle or stellate mesenchymal cells, without obvious atypia or increased mitotic index. The cells were arranged haphazardly in a dense fibrous stroma with thick walled vessels (H&E, ×100).

Mentions: At laparotomy, a large intra-abdominal mass was observed (Figure 2). The transversal colon and its mesocolon were stretched over the frontal side of the tumour and fixed to the mass (Figure 2). While its caudal side was mobile (Figure 3), the cranial side of the tumour was fixed focally to the inferior part of the tail of the pancreas (Figure 4). There was no infiltration of other organs. The tumour with the transverse colon, its mesocolon and a wide rim of the tail of the pancreas was resected en bloc. An end-to-end anastomosis of the ascending with the descending colon was performed. The postoperative course was uneventful. The tumour weighed 6.2 kg and was 33×29×8.5 cm in size. Histological examination demonstrated a mesenteric desmoid tumour (Figure 5) which had actually infiltrated the transverse colon as well as the surface of the resected part of the pancreas. The tumour appeared to have been excised completely. Immunohistochemical staining for oestrogen receptor alpha and progesterone was negative. No pathology was seen in the resected colon.


A giant pregnancy-associated intra-abdominal desmoid tumour: not necessarily a contraindication for subsequent pregnancy.

de Bree E, Dimitriadis E, Giannikaki E, Chryssou EG, Melissas J - World J Surg Oncol (2013)

Histological findings. Microscopically the tumour was composed of bland, spindle or stellate mesenchymal cells, without obvious atypia or increased mitotic index. The cells were arranged haphazardly in a dense fibrous stroma with thick walled vessels (H&E, ×100).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3852701&req=5

Figure 5: Histological findings. Microscopically the tumour was composed of bland, spindle or stellate mesenchymal cells, without obvious atypia or increased mitotic index. The cells were arranged haphazardly in a dense fibrous stroma with thick walled vessels (H&E, ×100).
Mentions: At laparotomy, a large intra-abdominal mass was observed (Figure 2). The transversal colon and its mesocolon were stretched over the frontal side of the tumour and fixed to the mass (Figure 2). While its caudal side was mobile (Figure 3), the cranial side of the tumour was fixed focally to the inferior part of the tail of the pancreas (Figure 4). There was no infiltration of other organs. The tumour with the transverse colon, its mesocolon and a wide rim of the tail of the pancreas was resected en bloc. An end-to-end anastomosis of the ascending with the descending colon was performed. The postoperative course was uneventful. The tumour weighed 6.2 kg and was 33×29×8.5 cm in size. Histological examination demonstrated a mesenteric desmoid tumour (Figure 5) which had actually infiltrated the transverse colon as well as the surface of the resected part of the pancreas. The tumour appeared to have been excised completely. Immunohistochemical staining for oestrogen receptor alpha and progesterone was negative. No pathology was seen in the resected colon.

Bottom Line: A potential aetiological role for female hormones is indicated.After a subsequent pregnancy, the patient delivered healthy twins 26 months later.Based on this case and a few others reported in the literature, subsequent pregnancy does not necessarily seem to be a risk factor for recurrent or new disease.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgical Oncology, Medical School of Crete University Hospital, Heraklion, Greece. debree@edu.uoc.gr.

ABSTRACT
Desmoid tumours are rare mesenchymal tumours, often locally invasive and characteristically associated with a high local recurrence rate after resection. A potential aetiological role for female hormones is indicated. Pregnancy-associated desmoid tumours are almost exclusively located in the abdominal wall. An essential issue is how to counsel women who have had a pregnancy-associated desmoid tumour and subsequently wish to bear a child. A considerably rare case of a patient with a resection of a giant pregnancy-associated, 33 cm in diameter, intra-abdominal desmoid tumour is presented. After a subsequent pregnancy, the patient delivered healthy twins 26 months later. Fifty-four months after treatment, there are no signs of recurrent or second desmoid tumour. Although rarely located in the abdomen, pregnancy-associated desmoid tumours should be included in the differential diagnosis of intra-abdominal tumours detected during or shortly after pregnancy. Based on this case and a few others reported in the literature, subsequent pregnancy does not necessarily seem to be a risk factor for recurrent or new disease.

Show MeSH
Related in: MedlinePlus