Desmoid Tumor Clinical Presentation

Updated: Mar 13, 2018
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
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Presentation

History

Although desmoid tumors can arise in any skeletal muscle, they most commonly develop in the anterior abdominal wall and shoulder girdle.

Retroperitoneal neoplasms are more common in familial polyposis coli and Gardner syndrome after abdominal surgery than in other conditions. [22]

Clusters of cases in families without evidence of any associated syndromes have also been reported. [23]

A history of trauma (often surgical) to the site of the desmoid tumor is elicited in 1 in 4 cases. [24] . Implant-associated breast desmoid tumors may occur. [25]

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Physical Examination

Peripheral desmoid tumors

Peripheral desmoid tumors are firm, smooth, and mobile. They often adhere to surrounding structures. The overlying skin is usually unaffected. The presence of such a soft tissue growth should alert the clinician to delve more deeply into the family history for evidence of familial polyposis coli and Gardner syndrome. Extra-abdominal desmoid tumors are rare and may be first evident as gradually increasing leg swelling. [26] Desmoid tumors may rarely appear on the foot. [27]

Intra-abdominal and extra-abdominal desmoid tumors

Intra-abdominal desmoid tumors may be seen. Extra-abdominal desmoid tumors may also be seen (rarely) in the urological system, including in the bladder and scrotum. [28, 29] Intra-abdominal desmoid tumors remain asymptomatic until their growth and infiltration cause visceral compression. Symptoms of intestinal, vascular, ureteric, or neural involvement may be the initial manifestations. An ethmoidal desmoid tumor has been described in a pediatric patient. [30]

Breast desmoid tumors

Desmoid tumors account for 0.2% of primary breast tumors, developing from muscular fasciae and aponeuroses. [31] Desmoid tumors may mimic breast cancer. [32]

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