Desmoid tumor pathophysiology: Difference between revisions
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===Mutations in adults=== | ===Mutations in adults=== | ||
*'''Wnt/beta-catenin signaling pathway''' | *'''Wnt/beta-catenin signaling pathway''' | ||
** | **Activating mutations in APC gene/Beta-catenin gene (CTNNB1) lead to dysregulation of beta-catenin levels in cell leading to its accumulation in nucleus which is associated with transcription activation of CYCD1 and MYC genes. | ||
**This leads to promotion of proliferation and enhanced survival associated with development of desmoid tumor.<ref name="pmid19099242">{{cite journal| author=Barker N| title=The canonical Wnt/beta-catenin signalling pathway. | journal=Methods Mol Biol | year= 2008 | volume= 468 | issue= | pages= 5-15 | pmid=19099242 | doi=10.1007/978-1-59745-249-6_1 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19099242 }} </ref><ref name="pmid19436199">{{cite journal| author=Lazar AJ, Hajibashi S, Lev D| title=Desmoid tumor: from surgical extirpation to molecular dissection. | journal=Curr Opin Oncol | year= 2009 | volume= 21 | issue= 4 | pages= 352-9 | pmid=19436199 | doi=10.1097/CCO.0b013e32832c9502 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19436199 }} </ref><ref name="pmid25838078">{{cite journal| author=Aitken SJ, Presneau N, Kalimuthu S, Dileo P, Berisha F, Tirabosco R et al.| title=Next-generation sequencing is highly sensitive for the detection of beta-catenin mutations in desmoid-type fibromatoses. | journal=Virchows Arch | year= 2015 | volume= 467 | issue= 2 | pages= 203-10 | pmid=25838078 | doi=10.1007/s00428-015-1765-0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25838078 }} </ref><ref name="pmid10597266">{{cite journal| author=Tejpar S, Nollet F, Li C, Wunder JS, Michils G, dal Cin P et al.| title=Predominance of beta-catenin mutations and beta-catenin dysregulation in sporadic aggressive fibromatosis (desmoid tumor). | journal=Oncogene | year= 1999 | volume= 18 | issue= 47 | pages= 6615-20 | pmid=10597266 | doi=10.1038/sj.onc.1203041 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10597266 }} </ref><ref name="pmid16505440">{{cite journal| author=Heinrich MC, McArthur GA, Demetri GD, Joensuu H, Bono P, Herrmann R et al.| title=Clinical and molecular studies of the effect of imatinib on advanced aggressive fibromatosis (desmoid tumor). | journal=J Clin Oncol | year= 2006 | volume= 24 | issue= 7 | pages= 1195-203 | pmid=16505440 | doi=10.1200/JCO.2005.04.0717 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16505440 }} </ref><ref name="pmid11983872">{{cite journal| author=Cheon SS, Cheah AY, Turley S, Nadesan P, Poon R, Clevers H et al.| title=beta-Catenin stabilization dysregulates mesenchymal cell proliferation, motility, and invasiveness and causes aggressive fibromatosis and hyperplastic cutaneous wounds. | journal=Proc Natl Acad Sci U S A | year= 2002 | volume= 99 | issue= 10 | pages= 6973-8 | pmid=11983872 | doi=10.1073/pnas.102657399 | pmc=124513 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11983872 }} </ref><ref name="pmid11823972">{{cite journal| author=Abraham SC, Reynolds C, Lee JH, Montgomery EA, Baisden BL, Krasinskas AM et al.| title=Fibromatosis of the breast and mutations involving the APC/beta-catenin pathway. | journal=Hum Pathol | year= 2002 | volume= 33 | issue= 1 | pages= 39-46 | pmid=11823972 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11823972 }} </ref><ref name="pmid17785554">{{cite journal| author=Signoroni S, Frattini M, Negri T, Pastore E, Tamborini E, Casieri P et al.| title=Cyclooxygenase-2 and platelet-derived growth factor receptors as potential targets in treating aggressive fibromatosis. | journal=Clin Cancer Res | year= 2007 | volume= 13 | issue= 17 | pages= 5034-40 | pmid=17785554 | doi=10.1158/1078-0432.CCR-07-0336 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17785554 }} </ref><ref name="pmid15654359">{{cite journal| author=Cheon S, Poon R, Yu C, Khoury M, Shenker R, Fish J et al.| title=Prolonged beta-catenin stabilization and tcf-dependent transcriptional activation in hyperplastic cutaneous wounds. | journal=Lab Invest | year= 2005 | volume= 85 | issue= 3 | pages= 416-25 | pmid=15654359 | doi=10.1038/labinvest.3700237 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15654359 }} </ref><ref name="pmid10570430">{{cite journal| author=Merchant NB, Lewis JJ, Woodruff JM, Leung DH, Brennan MF| title=Extremity and trunk desmoid tumors: a multifactorial analysis of outcome. | journal=Cancer | year= 1999 | volume= 86 | issue= 10 | pages= 2045-52 | pmid=10570430 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10570430 }} </ref><ref name="pmid26998061">{{cite journal| author=Kim HS, Kim J, Nam KH, Kim WH| title=Clinical significance of midkine expression in sporadic desmoid tumors. | journal=Oncol Lett | year= 2016 | volume= 11 | issue= 3 | pages= 1677-1684 | pmid=26998061 | doi=10.3892/ol.2016.4129 | pmc=4774436 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26998061 }} </ref><ref name="pmid17952864">{{cite journal| author=Kotiligam D, Lazar AJ, Pollock RE, Lev D| title=Desmoid tumor: a disease opportune for molecular insights. | journal=Histol Histopathol | year= 2008 | volume= 23 | issue= 1 | pages= 117-26 | pmid=17952864 | doi=10.14670/HH-23.117 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17952864 }} </ref><ref name="pmid26171757">{{cite journal| author=Crago AM, Chmielecki J, Rosenberg M, O'Connor R, Byrne C, Wilder FG et al.| title=Near universal detection of alterations in CTNNB1 and Wnt pathway regulators in desmoid-type fibromatosis by whole-exome sequencing and genomic analysis. | journal=Genes Chromosomes Cancer | year= 2015 | volume= 54 | issue= 10 | pages= 606-15 | pmid=26171757 | doi=10.1002/gcc.22272 | pmc=4548882 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26171757 }} </ref> | |||
**Following is a summary of all the events that occur at molecular level secondary to activating mutations in APC gene/Beta-catenin gene (CTNNB1)/Wnt signaling pathway, eventually leading to development of desmoid tumor. | |||
{{Family tree/start}} | {{Family tree/start}} | ||
{{Family tree | | | | A01 | | | |A01= External ligand binds }} | {{Family tree | | | | A01 | | | |A01= External ligand binds }} |
Revision as of 21:35, 27 February 2019
Desmoid tumor Microchapters |
Diagnosis |
---|
Treatment |
Case Studies |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sara Mohsin, M.D.[2]Faizan Sheraz, M.D. [3]
Overview
Desmoid tumor may occur as part of Gardner syndrome. A minority of desmoid tumors are associated with Turcot syndrome, Familial adenomatous polyposis, and estrogen therapy.
Pathophysiology
- Their exact aetiology remains uncertain, although they are frequently associated with previous trauma or surgical incision. On the molecular level, desmoids are characterised by mutations in the β-catenin gene, CTNNB1, or the adenomatous polyposis coli gene, APC.[1]
- The exact etiology of desmoid tumors is unknown. However, the following etiologies seem to play a role in development of desmoid tumors:[2][3][4][5][6]
Genetics
Mutations in adults
- Wnt/beta-catenin signaling pathway
- Activating mutations in APC gene/Beta-catenin gene (CTNNB1) lead to dysregulation of beta-catenin levels in cell leading to its accumulation in nucleus which is associated with transcription activation of CYCD1 and MYC genes.
- This leads to promotion of proliferation and enhanced survival associated with development of desmoid tumor.[7][8][9][10][11][12][13][14][15][16][17][18][19]
- Following is a summary of all the events that occur at molecular level secondary to activating mutations in APC gene/Beta-catenin gene (CTNNB1)/Wnt signaling pathway, eventually leading to development of desmoid tumor.
External ligand binds | |||||||||||||||||||
Wnt pathway activation | |||||||||||||||||||
Inhibition of kinase activity of APC complex (which tightly binds and regulates Beta-catenin levels by its phosphorylation in proteasome leading to its destruction) | |||||||||||||||||||
Elevated Beta-catenin levels in cell (due to non-phosphorylation) | |||||||||||||||||||
Beta-catenin translocates to nucleus | |||||||||||||||||||
B-catenin acts with other proteins to activate transcription of genes such as CYCD1 and MYC | |||||||||||||||||||
Promotion of proliferation and enhanced survival | |||||||||||||||||||
- APC mutations[4][20][21][22][23][24][25][26][27][28][6][29]
- Mutations in CTNNB1 (Beta-catenin gene) (64%) (sporadic desmoids) [8][30][31]
- Sporadic tumors and trisomy 8 and 20[32][33][34][35][36]
Additional mutations in pediatric desmoids
- In addition to CTNNB1 mutations, following mutations contribute to pediatric desmoids:[37]
- AKT1 E17K mutation (31%)
- BRAF V600E mutation (19%)
- TP53 R273H mutation (9%)
Associated Diseases
- Some cases have been associated with estrogen therapy
- Turcot syndrome
- Gardner syndrome
- Familial adenomatous polyposis
- In the case of mesenteric desmoid they are seen either sporadically or in association with familial polyposis coli syndrome(FAP)
Gross Pathology
- Abdominal wall desmoid tumors arise from:
- Musculoaponeurotic structures of the abdominal wall (especially the rectus and internal oblique muscles and their fascial coverings)
- External oblique muscle and the transversalis muscle or fascia
- These masses have a firm, gritty texture. On the cut surface, they are glistening white and coarsely trabeculated, resembling scar tissue
Location
Frequent locations in the abdomen are:
- Abdominal wall
- Root of the mesentery
- Retroperitoneum
Microscopic Pathology
Histologically, desmoid tumors consist of:[38]
- Elongated fibroblasts.
- Myofibroblasts characterized by elongated, tapered cytoplasm; elongated, vesicular, typical-appearing nuclei; and multiple small nucleoli. The cells are linearly arranged and are surrounded and separated from each other by collagen.
- These tumors show a tendency to evolve over time.
- Vandevenne et al described three stages of evolution of desmoid tumors:
- In the first stage, lesions are more cellular and have fewer areas of hyalinized collagen.
- In the second stage, there is an increasing amount of collagen deposition in the central and peripheral areas of the tumor.
- In the third stage, there is an increase in the fibrous composition with a decrease in cellularity and water content.
Reference
- ↑ Desmoid tumor. Dr Tim Luijkx and Radswiki et al. Radiopedia 2015 http://radiopaedia.org/articles/aggressive-fibromatosis. Accessed on January 20, 2015
- ↑ De Wever I, Dal Cin P, Fletcher CD, Mandahl N, Mertens F, Mitelman F; et al. (2000). "Cytogenetic, clinical, and morphologic correlations in 78 cases of fibromatosis: a report from the CHAMP Study Group. CHromosomes And Morphology". Mod Pathol. 13 (10): 1080–5. doi:10.1038/modpathol.3880200. PMID 11048801.
- ↑ Middleton SB, Frayling IM, Phillips RK (2000). "Desmoids in familial adenomatous polyposis are monoclonal proliferations". Br J Cancer. 82 (4): 827–32. doi:10.1054/bjoc.1999.1007. PMC 2374411. PMID 10732754.
- ↑ 4.0 4.1 Li C, Bapat B, Alman BA (1998). "Adenomatous polyposis coli gene mutation alters proliferation through its beta-catenin-regulatory function in aggressive fibromatosis (desmoid tumor)". Am J Pathol. 153 (3): 709–14. PMC 1853030. PMID 9736021.
- ↑ Escobar C, Munker R, Thomas JO, Li BD, Burton GV (2012). "Update on desmoid tumors". Ann Oncol. 23 (3): 562–9. doi:10.1093/annonc/mdr386. PMID 21859899.
- ↑ 6.0 6.1 Giarola M, Wells D, Mondini P, Pilotti S, Sala P, Azzarelli A; et al. (1998). "Mutations of adenomatous polyposis coli (APC) gene are uncommon in sporadic desmoid tumours". Br J Cancer. 78 (5): 582–7. PMC 2063069. PMID 9744495.
- ↑ Barker N (2008). "The canonical Wnt/beta-catenin signalling pathway". Methods Mol Biol. 468: 5–15. doi:10.1007/978-1-59745-249-6_1. PMID 19099242.
- ↑ 8.0 8.1 Lazar AJ, Hajibashi S, Lev D (2009). "Desmoid tumor: from surgical extirpation to molecular dissection". Curr Opin Oncol. 21 (4): 352–9. doi:10.1097/CCO.0b013e32832c9502. PMID 19436199.
- ↑ Aitken SJ, Presneau N, Kalimuthu S, Dileo P, Berisha F, Tirabosco R; et al. (2015). "Next-generation sequencing is highly sensitive for the detection of beta-catenin mutations in desmoid-type fibromatoses". Virchows Arch. 467 (2): 203–10. doi:10.1007/s00428-015-1765-0. PMID 25838078.
- ↑ Tejpar S, Nollet F, Li C, Wunder JS, Michils G, dal Cin P; et al. (1999). "Predominance of beta-catenin mutations and beta-catenin dysregulation in sporadic aggressive fibromatosis (desmoid tumor)". Oncogene. 18 (47): 6615–20. doi:10.1038/sj.onc.1203041. PMID 10597266.
- ↑ Heinrich MC, McArthur GA, Demetri GD, Joensuu H, Bono P, Herrmann R; et al. (2006). "Clinical and molecular studies of the effect of imatinib on advanced aggressive fibromatosis (desmoid tumor)". J Clin Oncol. 24 (7): 1195–203. doi:10.1200/JCO.2005.04.0717. PMID 16505440.
- ↑ Cheon SS, Cheah AY, Turley S, Nadesan P, Poon R, Clevers H; et al. (2002). "beta-Catenin stabilization dysregulates mesenchymal cell proliferation, motility, and invasiveness and causes aggressive fibromatosis and hyperplastic cutaneous wounds". Proc Natl Acad Sci U S A. 99 (10): 6973–8. doi:10.1073/pnas.102657399. PMC 124513. PMID 11983872.
- ↑ Abraham SC, Reynolds C, Lee JH, Montgomery EA, Baisden BL, Krasinskas AM; et al. (2002). "Fibromatosis of the breast and mutations involving the APC/beta-catenin pathway". Hum Pathol. 33 (1): 39–46. PMID 11823972.
- ↑ Signoroni S, Frattini M, Negri T, Pastore E, Tamborini E, Casieri P; et al. (2007). "Cyclooxygenase-2 and platelet-derived growth factor receptors as potential targets in treating aggressive fibromatosis". Clin Cancer Res. 13 (17): 5034–40. doi:10.1158/1078-0432.CCR-07-0336. PMID 17785554.
- ↑ Cheon S, Poon R, Yu C, Khoury M, Shenker R, Fish J; et al. (2005). "Prolonged beta-catenin stabilization and tcf-dependent transcriptional activation in hyperplastic cutaneous wounds". Lab Invest. 85 (3): 416–25. doi:10.1038/labinvest.3700237. PMID 15654359.
- ↑ Merchant NB, Lewis JJ, Woodruff JM, Leung DH, Brennan MF (1999). "Extremity and trunk desmoid tumors: a multifactorial analysis of outcome". Cancer. 86 (10): 2045–52. PMID 10570430.
- ↑ Kim HS, Kim J, Nam KH, Kim WH (2016). "Clinical significance of midkine expression in sporadic desmoid tumors". Oncol Lett. 11 (3): 1677–1684. doi:10.3892/ol.2016.4129. PMC 4774436. PMID 26998061.
- ↑ Kotiligam D, Lazar AJ, Pollock RE, Lev D (2008). "Desmoid tumor: a disease opportune for molecular insights". Histol Histopathol. 23 (1): 117–26. doi:10.14670/HH-23.117. PMID 17952864.
- ↑ Crago AM, Chmielecki J, Rosenberg M, O'Connor R, Byrne C, Wilder FG; et al. (2015). "Near universal detection of alterations in CTNNB1 and Wnt pathway regulators in desmoid-type fibromatosis by whole-exome sequencing and genomic analysis". Genes Chromosomes Cancer. 54 (10): 606–15. doi:10.1002/gcc.22272. PMC 4548882. PMID 26171757.
- ↑ Bertario L, Russo A, Sala P, Eboli M, Giarola M, D'amico F; et al. (2001). "Genotype and phenotype factors as determinants of desmoid tumors in patients with familial adenomatous polyposis". Int J Cancer. 95 (2): 102–7. PMID 11241320.
- ↑ Schiessling S, Kihm M, Ganschow P, Kadmon G, Büchler MW, Kadmon M (2013). "Desmoid tumour biology in patients with familial adenomatous polyposis coli". Br J Surg. 100 (5): 694–703. doi:10.1002/bjs.9053. PMID 23334997.
- ↑ Nieuwenhuis MH, Vasen HF (2007). "Correlations between mutation site in APC and phenotype of familial adenomatous polyposis (FAP): a review of the literature". Crit Rev Oncol Hematol. 61 (2): 153–61. doi:10.1016/j.critrevonc.2006.07.004. PMID 17064931.
- ↑ Sinha A, Tekkis PP, Gibbons DC, Phillips RK, Clark SK (2011). "Risk factors predicting desmoid occurrence in patients with familial adenomatous polyposis: a meta-analysis". Colorectal Dis. 13 (11): 1222–9. doi:10.1111/j.1463-1318.2010.02345.x. PMID 20528895.
- ↑ Caspari R, Olschwang S, Friedl W, Mandl M, Boisson C, Böker T; et al. (1995). "Familial adenomatous polyposis: desmoid tumours and lack of ophthalmic lesions (CHRPE) associated with APC mutations beyond codon 1444". Hum Mol Genet. 4 (3): 337–40. PMID 7795585.
- ↑ Bertario L, Russo A, Sala P, Varesco L, Giarola M, Mondini P; et al. (2003). "Multiple approach to the exploration of genotype-phenotype correlations in familial adenomatous polyposis". J Clin Oncol. 21 (9): 1698–707. doi:10.1200/JCO.2003.09.118. PMID 12721244.
- ↑ Friedl W, Caspari R, Sengteller M, Uhlhaas S, Lamberti C, Jungck M; et al. (2001). "Can APC mutation analysis contribute to therapeutic decisions in familial adenomatous polyposis? Experience from 680 FAP families". Gut. 48 (4): 515–21. PMC 1728231. PMID 11247896.
- ↑ Wallis YL, Morton DG, McKeown CM, Macdonald F (1999). "Molecular analysis of the APC gene in 205 families: extended genotype-phenotype correlations in FAP and evidence for the role of APC amino acid changes in colorectal cancer predisposition". J Med Genet. 36 (1): 14–20. PMC 1762945. PMID 9950360.
- ↑ Church J, Xhaja X, LaGuardia L, O'Malley M, Burke C, Kalady M (2015). "Desmoids and genotype in familial adenomatous polyposis". Dis Colon Rectum. 58 (4): 444–8. doi:10.1097/DCR.0000000000000316. PMID 25751801.
- ↑ Halling KC, Lazzaro CR, Honchel R, Bufill JA, Powell SM, Arndt CA; et al. (1999). "Hereditary desmoid disease in a family with a germline Alu I repeat mutation of the APC gene". Hum Hered. 49 (2): 97–102. doi:10.1159/000022852. PMID 10077730.
- ↑ Lazar AJ, Tuvin D, Hajibashi S, Habeeb S, Bolshakov S, Mayordomo-Aranda E; et al. (2008). "Specific mutations in the beta-catenin gene (CTNNB1) correlate with local recurrence in sporadic desmoid tumors". Am J Pathol. 173 (5): 1518–27. doi:10.2353/ajpath.2008.080475. PMC 2570141. PMID 18832571.
- ↑ Mullen JT, DeLaney TF, Rosenberg AE, Le L, Iafrate AJ, Kobayashi W; et al. (2013). "β-Catenin mutation status and outcomes in sporadic desmoid tumors". Oncologist. 18 (9): 1043–9. doi:10.1634/theoncologist.2012-0449. PMC 3780636. PMID 23960186.
- ↑ Fletcher JA, Naeem R, Xiao S, Corson JM (1995). "Chromosome aberrations in desmoid tumors. Trisomy 8 may be a predictor of recurrence". Cancer Genet Cytogenet. 79 (2): 139–43. PMID 7889507.
- ↑ Kouho H, Aoki T, Hisaoka M, Hashimoto H (1997). "Clinicopathological and interphase cytogenetic analysis of desmoid tumours". Histopathology. 31 (4): 336–41. PMID 9363449.
- ↑ Bridge JA, Swarts SJ, Buresh C, Nelson M, Degenhardt JM, Spanier S; et al. (1999). "Trisomies 8 and 20 characterize a subgroup of benign fibrous lesions arising in both soft tissue and bone". Am J Pathol. 154 (3): 729–33. doi:10.1016/S0002-9440(10)65319-9. PMC 1866419. PMID 10079250.
- ↑ Qi H, Dal Cin P, Hernández JM, Garcia JL, Sciot R, Fletcher C; et al. (1996). "Trisomies 8 and 20 in desmoid tumors". Cancer Genet Cytogenet. 92 (2): 147–9. PMID 8976373.
- ↑ Mertens F, Willén H, Rydholm A, Brosjö O, Carlén B, Mitelman F; et al. (1995). "Trisomy 20 is a primary chromosome aberration in desmoid tumors". Int J Cancer. 63 (4): 527–9. PMID 7591262.
- ↑ Meazza C, Belfiore A, Busico A, Settanni G, Paielli N, Cesana L; et al. (2016). "AKT1 and BRAF mutations in pediatric aggressive fibromatosis". Cancer Med. 5 (6): 1204–13. doi:10.1002/cam4.669. PMC 4924379. PMID 27062580.
- ↑ Economou, Athanasios; Pitta, Xanthi; Andreadis, Efstathios; Papapavlou, Leonidas; Chrissidis, Thomas (2011). "Desmoid tumor of the abdominal wall: a case report". Journal of Medical Case Reports. 5 (1): 326. doi:10.1186/1752-1947-5-326. ISSN 1752-1947.