Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 16, 2024; 12(8): 1467-1473
Published online Mar 16, 2024. doi: 10.12998/wjcc.v12.i8.1467
Malignant triton tumor in the abdominal wall: A case report
Ho Jik Yang, Donghyun Kim, Won Suk Lee, Sang-Ha Oh
Ho Jik Yang, Department of Plastic and Reconstructive Surgery, Chungnam National University Sejong Hospital, Sejong 30099, South Korea
Donghyun Kim, Department of Plastic and Reconstructive Surgery, Chungnam National University Hospital, Daejeon 35015, South Korea
Won Suk Lee, Department of Emergency, Eulji University Hospital, Daejeon 35233, South Korea
Sang-Ha Oh, Department of Plastic and Reconstructive Surgery, Chungnam National University College of Medicine, Daejeon 35015, South Korea
Author contributions: Yang HJ and Kim D wrote and edited the manuscript and performed data collection; Lee WS contributed to data analysis; Oh SH contributed to conceptualization and supervision; All authors have read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sang-Ha Oh, MD, PhD, Professor, Surgeon, Department of Plastic and Reconstructive Surgery, Chungnam National University College of Medicine, 282, Munwha-ro, Jung-gu, Daejeon 35015, South Korea. djplastic@cnu.ac.kr
Received: November 24, 2023
Peer-review started: November 24, 2023
First decision: January 9, 2024
Revised: January 16, 2024
Accepted: February 6, 2024
Article in press: February 6, 2024
Published online: March 16, 2024
Processing time: 109 Days and 6 Hours
Abstract
BACKGROUND

Malignant triton tumors (MTTs) comprise a subgroup of malignant peripheral nerve sheath tumors (MPNSTs) that exhibits rhabdomyosarcomatous differentiation and follow an aggressive course. MTTs are primarily located along peripheral nerves. Cases of MTTs in the abdominal wall have not been reported. MTT has a poorer prognosis than classic MPNSTs, and accurate diagnosis necessitates a keen understanding of the clinical history and knowledge of its differential diagnosis intricacies. Treatment for MTTs mirrors that for MPNSTs and is predominantly surgical.

CASE SUMMARY

A 49-year-old woman presented with a subcutaneous mass in her lower abdominal wall and a pre-existing surgical scar that had grown slowly over 3-4 months before the consultation. She had previously undergone radical hysterectomy and concurrent chemo-radiotherapy for cervical cancer approximately 5 years prior to the consultation. Abdominal computed tomography (CT) showed a 1.3 cm midline mass in the lower abdomen with infiltration into the rectus abdominis muscle. There was no sign of metastasis (T1N0M0). An incisional biopsy identified sporadic MTT of the lower abdomen. A comprehensive surgical excision with a 3 cm margin inclusive of the peritoneum was executed. Subsequently, the general surgeon utilized an approach akin to the open peritoneal onlay mesh technique. The patient underwent additional treatment with an excision shaped as a mini-abdominoplasty for the skin defect. No complications arose, and annual follow-up CTs did not show signs of recurrence or metastasis.

CONCLUSION

An abdominal MTT was efficaciously treated with extensive excision and abdominal wall reconstruction, eliminating the need for postoperative radiotherapy.

Keywords: Malignant triton tumor; Abdominal wall; Surgical excision; Reconstruction; Case report

Core Tip: Malignant triton tumor is an uncommon condition characterized by a poor prognosis. Cases emerging in the abdominal wall are especially rare. Swift differential diagnosis and comprehensive surgical removal play a pivotal role in management. In this instance, we managed to treat the patient without the necessity for postoperative radiotherapy, thanks to a wide excision complemented by suitable reconstruction.