DESMOID TUMOR ARISING IN A LAPAROSCOPIC TROCAR SITE

Desmoid tumors are fibrotic neoplasms of low metastatic potential. The se tumors have long been associated with major laparotomy incisions. H owever, to the best of our knowledge, they have not been previously as sociated with laparoscopic trocar placement. This report involves the case of a patient who developed a desmoid tumor at a trocar site. A 35 year-old premenopausal woman presented with an enlarging infraumbilic al mass 10 years after a laparoscopic tubal ligation. The mass was imm ediately subjacent to the skin incision for the laparoscopic procedure . It was approximately 6 cm in diameter and fixed to the underlying ab dominal wall. It was evaluated with sonographic and CT imaging, which revealed a solid mass arising from the fascia with no associated herni a. A biopsy of the mass confirmed a diagnosis of a desmoid tumor. This was subsequently excised with a wide margin and reconstructed with Ma rlex mesh. The patient is without recurrence 2 years following surgery . This case represents what we believe to be the first report of a des moid tumor arising from an incision made for the placement of a laparo scopic port. Rapidly increasing laparoscopic applications make it like ly that these lesions will increase in frequency. In this setting, res ection with wide margins remains the mainstay of treatment for desmoid tumors.