Management of desmoid tumours including a case report of toremifene

A previously fit 17-year-old female presented with a swelling in the left loin region. This was associated with episodes of moderately severe pain of a constant nature, but no other symptoms. Clinical examination revealed a smooth, fixed mass in the left upper abdominal quadrant. A CT scan (Fig. 1) showed an extensive left-sided retroperitoneal soft-tissue mass extending posteriorly between the psoas muscle and vertebrae. The mass was in close apposition to the left side of the abdominal aorta, and encased almost the entire circumference of the common iliac artery and part of the corresponding vein on that side. There was infiltration of the mesentery and psoas muscle with obstruction of the left ureter and a grossly hydronephrotic kidney (Fig. 2). An IVU confirmed the latter finding, though a DPTA scan demonstrated preservation of renal function (differential function approx. 50:50).