Large anterior abdominal wall desmoid tumor: A technical challenge in abdominal wall reconstruction in a young female

Desmoid tumors of the anterior abdominal wall are rare, locally aggressive, benign fibroblastic neoplasms frequently associated with pregnancy or prior abdominal surgery.Large lesions often require wide excision, resulting in complex abdominal wall defects that pose significant reconstructive challenges.We report a 32-year-old female who presented with a rapidly enlarging left lower abdominal wall mass one year after cesarean section.Imaging demonstrated an 8.1 × 5.5 × 7 cm well-defined soft-tissue lesion arising from the left rectus abdominis muscle without intraperitoneal extension.Wide local excision resulted in a 14 × 10 cm full-thickness abdominal wall defect, which was reconstructed using posterior component separation with bilateral transversus abdominis release and retro-rectus polypropylene mesh placement.Histopathology confirmed desmoid fibromatosis with negative surgical margins.The postoperative course was uneventful, with no evidence of recurrence at five months of follow-up.This case highlights the characteristic postpartum presentation of abdominal wall desmoid tumors and demonstrates that posterior component separation with bilateral transversus abdominis release provides a reliable and durable reconstructive option for large abdominal wall defects following radical excision.