Published online Jun 24, 2014. doi: 10.5500/wjt.v4.i2.148
Revised: May 6, 2014
Accepted: June 10, 2014
Published online: June 24, 2014
Processing time: 131 Days and 6.2 Hours
We are reporting the first documented case of an abdominal desmoid tumor presenting primarily after liver transplantation. This tumor, well described in the literature as occurring both in conjunction with familial adenomatous polyposis as well as in the post-surgical patient, has never been noted after solid organ transplantation and was therefore not included in our differential upon presentation. Definitive diagnosis required the patient to undergo surgical excision and immunochemical staining of the mass for confirmation. A review of the literature showed no primary tumors after transplantation. In a population of patients who received a small bowel transplant after they developed short gut post radical resection of aggressive fibromatosis, only rare recurrences were seen. No connection of tumor development with immunosuppression or need to decrease immunosuppressant treatment has been demonstrated in these patients. Our case and the literature show the risk of this tumor presenting in the post-transplantation patient and the need for a high index of suspicion in patients who present with a complex mass after transplantation to prevent progression of the disease beyond a resectable lesion. Results of a thorough search of the literature are detailed and the medical and surgical management of both resectable and unresectable lesions is reviewed.
Core tip: Desmoid tumor is a soft tissue tumor seen primarily after surgical resection. A high index of suspicion is necessary as delayed diagnosis can cause significant morbidity with resection. This case presents the first observed desmoid after liver transplantation as well as a literature search detailing the observed desmoid presentations in the context of immunosuppression.