A desmoid tumour is a benign, non-inflammatory fibroblastic tumour (see WHO 2002 classification of soft tissue tumours) with a tendency to local invasion and recurrence but without metastasis.
Desmoid tumours are found in all age groups but are most frequently encountered between 20 and 40 years of age. They are seen more in women (2:1). They are rare lesions with an estimated incidence of 3 or 4 new cases per million population per year.
Their exact etiology remains uncertain, although they are frequently associated with previous trauma or surgical incision.
Desmoid tumours present as masses, and as such presentation depends on location.
- some cases have been associated with oestrogen therapy
- in the case of mesenteric desmoid they are seen either sporadically or in association with familial polyposis coli syndrome (FAP).
Frequent locations in the abdomen are the abdominal wall, the root of the mesentery and the retroperitoneum.
Desmoid tumours typically appear as homogeneously anechoic or hypoechoic masses. As such they should not be confused with cystic lesions.
Most desmoid tumors are well circumscribed masses, although in some cases they may appear more aggressive with ill-defined margins.
In terms of density most are relatively homogeneously or focally hyperattenuating when compared to soft tissue on the non-contrast scan.
Most desmoids will demonstrate enhancement following administration of intravenous contrast.
MRI, as is the case with other soft tissue tumours, is more sensitive to local tumour extension. Their appearance is accounted for by their dense cellularity. Typical signal characteristics include
- T1 - low signal intensity
- T2 - low signal intensity
Treatment and prognosis
- Surgical resection (recurrence rate high)
- NSAIDs and anti-oestrogens can be used to reduce the rate of recurrence
- 1. Einstein DM, Tagliabue JR, Desai RK. Abdominal desmoids: CT findings in 25 patients. AJR Am J Roentgenol. 1991;157 (2): 275-9. AJR Am J Roentgenol (abstract) - Pubmed citation
- 2. Teo HE, Peh WC, Shek TW. Case 84: desmoid tumor of the abdominal wall. Radiology. 2005;236 (1): 81-4. doi:10.1148/radiol.2361031038 - Pubmed citation
- 3. Dinauer PA, Brixey CJ, Moncur JT et-al. Pathologic and MR imaging features of benign fibrous soft-tissue tumors in adults. Radiographics. 2007;27 (1): 173-87. Radiographics (full text) - doi:10.1148/rg.271065065 - Pubmed citation
- 4. Faria SC, Iyer RB, Rashid A et-al. Desmoid tumor of the small bowel and the mesentery. AJR Am J Roentgenol. 2004;183 (1): 118. doi:10.2214/ajr.183.1.1830118 - Pubmed citation
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