Abdominal desmoid tumor (Abdominal desmoid fibromatosis

Deba P Sarma, MD Omaha

F 33, abdominal wall soft tissue mass,7.5 x6x3 cm, 61 g, pinkwhite, whorled, trabecular cut surface.

Vimentin: Positive

SMA: Positive

Desmin: Focally positive. Notice the strongly positive skeletal muscle on the left.

Beta catenin: Positive with condensation in the nuclei.

S 100: Negative.

CD 34: Spindle cells are negative. Notice the positive blood vessels.

Diagnosis: Abdominal desmoid tumor
Mostly in females, 15-40 yrs, frequently during or soon after pregnancy. Deeply infiltrative fibroproliferative lesion involving fascia and muscle of abdominal wall. Rarely associated with familial polyposis/Gardner syndrome. Overall recurrence: 30%

Pathology: Cytologically bland, spindly fibroblastic cells in fascicles or haphazardly infiltrating into the fascia and skeletal muscle. Low to moderate cellularity, no or few normal mitoses, no atypical mitosis. No necrosis or hemorrhage.

Immunostaining: Actin: Positive, Desmin: Focally positive, Beta catenin: Positive, Vimentin: Positive. CD34: Negative, S-100: Negative, Cytokeratin: Negative.

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