Intra-abdominal desmoid tumor following retroperitoneal lymph node dissection for testicular germ cell tumor

Department of Urology, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
International Journal of Urology (Impact Factor: 2.41). 02/2006; 13(1):84-6. DOI: 10.1111/j.1442-2042.2006.01231.x
Source: PubMed


In the testicular cancer post-treatment setting a rapidly growing retroperitoneal mass leads to a differential diagnosis including recurrent germ cell tumor, residual mature teratoma, or sarcomatoid degeneration. We report the case of a 27-year-old man with a large abdominal mass occurring in the setting of a mixed germ cell tumor after radical orchiectomy with primary chemotherapy followed by retroperitoneal lymph node dissection. Surgical excision of this mass followed by pathological review revealed an intra-abdominal desmoid tumor. Fluorescence in situ hybridization (FISH) for isochromosome 12p failed to demonstrate a germ cell tumor origin. This is the fourth such case of an intra-abdominal desmoid tumor after retroperitoneal lymph node dissection for testicular cancer in the urologic literature. This case highlights the need for careful consideration of a desmoid tumor when a rapidly growing spindle cell tumor is encountered in a post-treatment testis cancer patient.

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Available from: Milton W Datta, Oct 05, 2015
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    • "IAF has been observed in the sites of previous abdominal surgery for tumors [23,24]. Its diagnosis often is difficult to establish preoperatively, and it is usually misdiagnosed as recurrence at first clinical impression [2,22,23,27]. Surgical excision of the lesion is a difficult decision owing to the suspicion of metastasis mainly due to the following reasons. 1) The appearance of IAF on contrast enhanced imaging is not specific, therefore, the imaging diagnosis of IAF developed after abdominal surgery for other tumors is very difficult except in patients with familial adenomatous polyposis [20,28]. "
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    ABSTRACT: Report of one case of desmoid tumor in a patient who had been treated of a testicular seminoma 26 months before, with excision of a retroperitoneal mass and chemotherapy. On followup he presented with a mesenteric abdominal mass which was clinically labeleled as a recurrence of the seminoma. Histologically it was reported as a mesenteric desmoid tumor. Differential diagnosis with gastrointestinal stromal tumor was performed with immunohistochemical studies. Desmoid tumor is rare. There are few cases reported in patients with history of previous testicular tumor. It should be included in the differential diagnosis of testicular tumor recurrences.
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