Desmoid-type fibromatosis (DTF) is a rare, locally aggressive myofibroblastic neoplasm. Abdominal wall occurrences are frequently associated with antecedent surgical trauma, such as Cesarean sections, and pregnancy-related hormonal factors. The diagnosis is challenging and requires differentiation from scar endometriosis. We report the case of a 35-year-old woman presenting with a painful infraumbilical mass 4 years after her last Cesarean section. Magnetic Resonance Imaging (MRI) suggested a desmoid tumor, characterized by T2 hypointensity and fascial infiltration. Percutaneous biopsy confirmed the diagnosis, revealing nuclear beta-catenin positivity and negative hormone receptors. Following multidisciplinary assessment and in accordance with the patient's preference, a conservative management strategy using nonsteroidal anti-inflammatory drugs (NSAIDs) was initiated, resulting in symptomatic relief. This case underscores the importance of MRI in the diagnostic workup and highlights the role of active surveillance and medical management as a viable first-line strategy for symptomatic abdominal wall DTF.
Abdallah et al. (Tue,) studied this question.