A Case Report of an Abdominal Wall Desmoid Tumor Treated by Dual-Mesh Reconstruction

Abstract

Background: Desmoid tumors, also known as aggressive fibromatosis, are rare benign fibroblastic neoplasms characterized by locally aggressive behavior and a high risk of recurrence. Involvement of the abdominal wall is uncommon and may present significant reconstructive challenges following wide surgical excision. Abdominal wall desmoid tumors predominantly affect young women and may occur sporadically or in association with familial adenomatous polyposis. Aim: The aim of the study is to present a case of a large abdominal wall desmoid tumor managed surgically, with particular emphasis on the role of dual-mesh prosthetic reconstruction in addressing extensive parietal tissue loss. Case Presentation: We report the case of a 22-year-old woman with no significant medical history who presented with a one-year history of constipation associated with right lower quadrant and lumbar pain. Physical examination revealed a large, mobile parietal mass in the right iliac fossa. Abdominal magnetic resonance imaging demonstrated a large right-sided mass arising from the right rectus abdominis muscle. An ultrasound-guided core needle biopsy confirmed the diagnosis of a desmoid tumor. The patient underwent complete surgical resection with wide margins, including total excision of the infraumbilical portion of the right rectus abdominis muscle. Abdominal wall reconstruction was performed using a dual-face prosthetic mesh fixed to the peritoneum and covered by the remaining aponeurosis. Postoperative recovery was uneventful, and the patient was discharged on postoperative day three. Follow-up at 15 days was satisfactory. Conclusion: This case underscores the value of dual-mesh prostheses in abdominal wall reconstruction after extensive resection of desmoid tumors, enabling safe coverage of large parietal defects with favorable short-term outcome.