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General Surgery · Abdominal wall: desmoid tumour
Sample itemA 28-year-old woman has a firm, painless, non-tender mass within the rectus abdominis 8 months after delivery. Biopsy shows bland spindle cells infiltrating muscle without metastasis. Which condition is this tumour associated with?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Familial adenomatous polyposis (APC mutation)
Desmoid (aggressive fibromatosis) arises from musculoaponeurotic tissue, often in the anterior abdominal wall after pregnancy or surgery. It is locally infiltrative and recurs but does not metastasise. It occurs in Gardner syndrome, a variant of FAP, through APC or CTNNB1 mutation, so colonoscopy is advised.
Option by option
A. Lynch syndrome
Lynch syndrome causes colorectal and endometrial cancers, not desmoids.
B. MEN1
MEN1 causes parathyroid, pituitary and pancreatic tumours.
C. Familial adenomatous polyposis (APC mutation) (correct)
Correct. Desmoids are strongly associated with FAP and Gardner syndrome.
D. Peutz-Jeghers syndrome
Peutz-Jeghers causes hamartomatous polyps and mucocutaneous pigmentation.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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