Unrecognized complication of gastric bypass: a rare case of intraabdominal desmoid tumor

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Geoffrey Jacqmin (1), Geanina Curca (1), Mikhael Janssen (2), Christophe Boland (3), David Heuker (1) Published in the journal : November 2019 Category : Chirurgie digestive

Summary :

Desmoid tumors are rare monoclonal myofibroblastic proliferations with varying clinical courses depending on the disease location and extent. Despite being comprised of histologically benign stromal cell proliferations, these growths can, at times, become locally aggressive and have a high rate of local reccurence, even following complete resection. To date, there are no reports of metastases in the literature. Although various risk factors have been described, the etiologies and pathways of these cell growths are not completely understood. Desmoid tumors occur either as sporadic lesions or as part of familial adenomatous polyposis, which is caused by germ line mutations in the adenomatous polyposis coli gene. Due to their different clinical presentations, no standard approach for desmoid tumors has been recommended so far. Herein, we describe the case of a 46-year-old female who had undergone gastric bypass three years earlier, whilst being diagnosed with a mesenteric desmoid tumor that compressed her Roux-en-Y jejunal limb. To our knowledge, this is the first reported case of desmoid tumor in a patient having undergone a Roux-en-Y gastric bypass.

Key Words

Desmoid tumor, Postopertive complication, Roux-en-Y gastric bypass, Obesity

What is already known about the topic?

Desmoid tumors exhibit varying clinical presentations that are mainly linked to organ location and loco-regional extension. Despite its low incidence, surgery should be considered as a potential risk factor when confronted with a desmoid tumor.

What does this article bring up for us?

This case report aims at informing the reader of the common characteristics of desmoid tumors, with a major focus on surgery as a potential risk factor. In this article, we have discussed the basic management of desmoid tumors, in addition to promoting active surveillance as the recommended follow-up practice.