Desmoid-Type Fibromatosis of the Rectus Abdominis: an Uncommon Anatomical Manifestation

Tarun V Prudvi Varma Pinnamraju; Surya Rao R V M; Sudarshan P B; Mohamed Rifath; Sherine Valentina

doi:10.36948/ijfmr.2026.v08i03.79046

Desmoid-Type Fibromatosis of the Rectus Abdominis: an Uncommon Anatomical Manifestation

Author(s)	Dr Tarun V Prudvi Varma Pinnamraju, Dr Surya Rao R V M, Dr Sudarshan P B, Dr Mohamed Rifath, Dr Sherine Valentina
Country	India
Abstract	A female patient presented with irregular menstrual cycles and a progressively enlarging lower abdominal swelling two years after undergoing a lower-segment cesarean section. Clinical examination revealed a large, firm abdominal wall mass extending from the right iliac fossa into the umbilical region with restricted mobility and attachment to the abdominal wall. Magnetic resonance imaging demonstrated a well-defined solid mass arising from the right rectus sheath, compressing adjacent pelvic structures including the urinary bladder and uterus while preserving fat planes. Trucut biopsy with immunohistochemistry confirmed desmoid-type fibromatosis, showing strong nuclear β-catenin positivity along with smooth muscle actin expression and low proliferative activity. The patient underwent neoadjuvant chemotherapy followed by wide local excision of the tumor. Intraoperatively, the lesion was found adherent to surrounding structures including the bladder, uterus, and pubic symphysis, necessitating extensive resection involving the rectus muscles and peritoneum. The resulting large abdominal wall defect required complex reconstruction using bilateral transversus abdominis release, polypropylene mesh reinforcement, fascia lata grafting, and rotational flap coverage to restore structural integrity. This case highlights the rare presentation of desmoid-type fibromatosis arising from the rectus abdominis following cesarean section and emphasizes the importance of multidisciplinary management. Accurate diagnosis through imaging and immunohistochemistry, combined with meticulous surgical planning and advanced reconstructive techniques, is essential for achieving optimal functional and oncological outcomes in extensive abdominal wall desmoid tumors.
Keywords	Desmoid Tumor, Abdominal Wall Reconstruction, Tensor Fascia Lata Flap, Tensor Fascia Lata Graft, B-Catenin
Field	Medical / Pharmacy
Published In	Volume 8, Issue 3, May-June 2026
Published On	2026-05-20
DOI	https://doi.org/10.36948/ijfmr.2026.v08i03.79046

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Desmoid-Type Fibromatosis of the Rectus Abdominis: an Uncommon Anatomical Manifestation

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