Oncological Pathology of the Abdominal Wall: A Challenge for Abdominal Wall Surgeons

Introduction Mesenchymal tumors are the tumor line that most frequently affects the abdominal wall. This pathological category includes all neoformations of mesenchymal tissues, muscle, vessels, adipose tissue, among others. They are rare tumors that require extensive extirpations and complex reconstructions. Aim To point out the importance of multidisciplinary units to provide patients the best oncological, functional and aesthetic results. Material and Methods We present a case series of patients affected by abdominal wall tumors of mesenchymal type, who have received treatment in the sarcoma unit of San Carlos Clinical Hospital in Madrid between 2015 and 2023. The sarcoma unit includes, among other specialists, abdominal wall and plastic surgeons. Results A total of 17 patients have received surgery, there were 9 males and 8 females. The average age was 58 years. The inguinal region and the root of the thigh were the most affected sites (9). The most common tumor type was liposarcoma (5). The remaining cases were femoral sheath leiomyosarcoma, schwannoma, chondrosarcomas and osteosarcomas. The surgical treatment of these patients required vascular and osteoarticular reconstruction by expert surgeons in these areas. The tumor line that most frequently involved the anterior wall of the abdomen were tumors of fibroblast origin. These cases required extensive excisions of the entire abdominal wall which was reconstructed using different types of flaps performed by plastic surgeons. Conclusions The treatment of abdominal wall tumor pathology should be carried out in reference units and by multidisciplinary surgical teams as different organs and systems are usually affected.