JSCR 2014; 3 (1 pages) doi:10.1093/jscr/rju011

Case Report

A painless swelling of the abdominal wall D.-A.A. Lamprou* and L.G. van der Hem Department of Surgery, Deventer Hospital, Deventer, The Netherlands *Correspondence address. Department of Surgery, Deventer Hospital, Deventer, The Netherlands. Tel: þ31-5-70-53-53-53; Fax: þ31-570-501-419; E-mail: [email protected] Received 6 December 2013; accepted 29 January 2014

INTRODUCTION A general physician refers a 77-year-old male with no previous illnesses to the department of surgery. At the time of presentation a subcostal swelling of the abdominal wall has been present for over 5 months. This painless swelling has progressively grown in size over the past few months.

CASE REPORT On palpation the lesion is solid elastic to the touch. An ultrasound investigation with histological biopsy was made.

Histological examination showed fibroma myxoid tissue with the suspicion on nodular fasciitis. Additional CAT-scan images (Fig. 1) revealed a smooth, oval and the peritoneumbordered tumour located medially and spreading into the rectus abdominis muscle. During surgery a large yellow lobular partially fibrotic mass (Fig. 2) was excised located entirely above the muscle fascia. Histological examination showed nodular fasciitis without signs of malignancy.

DISCUSSION Nodular fasciitis, also known as pseudosarcomatous fibromatosis, is predominately seen in young adults (20 – 40 years). Mostly affecting the upper extremities or trunk it can mimic a malignant sarcoma due to its rapid growth.

Figure 1: CT abdomen: lesion in the abdominal wall, possibly originating from the rectus abdominis muscle.

Figure 2: Tumour ex vivo, note the lobular structure with fibrous septa (incised).

Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. # The Author 2014. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/3.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact [email protected]

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Case report. A man with a painless swelling of the abdominal wall. A 77-year-old male presented with a progressively increasing painless swelling of the abdominal wall due to nodular fasciitis.

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A painless swelling of the abdominal wall.

Case report. A man with a painless swelling of the abdominal wall. A 77-year-old male presented with a progressively increasing painless swelling of t...
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