A rare and interesting case of desmoid-type fibromatosis arising from the fat layer of the abdominal wall: A case report

Abstract

\n Background\n\nDesmoid-type fibromatosis (DTF) is a rare kind of soft-tissue tumors of unknown origin, which is a benign mesenchymal neoplasm with monoclonal proliferation with local invasion, easy recurrence and non-distant metastasis. It is usually arising from the aponeurosis, muscle, and deep fascia, but DTF arsing from the fat layer have not been previously reported.\nCase presentation:\n\nA 22-year-old male was presented with a recurrence of lower abdominal wall mass(LAWM) after multiple operations and a new mass in the skin flap donor area of the right abdominal wall. Magnetic resonance imaging (MRI) revealed multiple soft tissue masses and nodules in the subcutaneous fat layer of the lower abdomen and right abdomen wall, which was considered a diagnosis of fibrosarcoma, then pathological consultation was performed on the paraffin specimens from previous operations, and finally confirmed the diagnosis of desmoid-type fibromatosis in combination with pathological characteristics of the resected specimens in this visit. In general, DTF did not have the ability to metastasize, but we extracted paraffin sections and performed full exon sequencing. After personalized analysis, the results showed that there was a possibility of implantative metastasis. Due to the aggressive growth and recurrence of the tumor, the patient was subsequently treated with radiotherapy and no recurrence was observed 6 months later. Continued follow-up is ongoing.\nConclusions\n\nWe report the first case of DTF that occurs in the superficial layer of fat with the possibility of surgically induced implantative metastasis, for such patients, diagnosis of DTF is more difficult and surgical treatment should be treated with greater caution.