{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T13:47:37Z","timestamp":1782740857232,"version":"3.54.5"},"reference-count":18,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,6,9]]},"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:p>Pelvic desmoid fibromatosis is a rare locally aggressive benign neoplasm, typically presenting in the reproductive age group with lower abdominal pain. Extra-abdominal occurrence being predominant, the pelvic origin of the tumour makes the clinical management a multidisciplinary challenge. Previous surgeries, current or previous pregnancies, and familial adenomatous polyposis have been documented as associated risk factors. Our patient was a young woman with three previous caesarean sections, admitted with a large infiltrative lesion extending into the left pelvic sidewall up to the pelvic bone, causing ipsilateral severe hydroureteronephrosis. Malignancy was suspected due to the infiltrating nature of the lesion on imaging. Due to its proximity to the pelvic veins, preoperative embolisation of the feeding vessel was done. An exploratory laparotomy was performed by a multidisciplinary team. For this deep-seated disease, mass excision was performed along with total hysterectomy, left salpingo-oophorectomy and left ureteroneocystostomy. A part of the lesion infiltrating the presacral fascia was not removed during the primary surgery. Within 24 hours of surgery, she developed critical limb ischaemia in the left limb due to thrombosis in the ipsilateral external iliac artery. An emergency thrombo-embolectomy was performed by the vascular surgeons and thromboprophylaxis continued. Final histopathology confirmed desmoid fibromatosis. For the residual disease, the patient has been under close follow-up and is receiving targeted therapy with oral sorafenib to prevent local progression. Her follow-up imaging showed a decrease in the size of the residual disease and she is asymptomatic currently.<\/jats:p>","DOI":"10.1136\/bcr-2025-271116","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T13:10:29Z","timestamp":1782738629000},"page":"e271116","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Pelvic desmoid fibromatosis: a diagnostic and therapeutic challenge"],"prefix":"10.1136","volume":"19","author":[{"given":"Anupama","family":"Bahadur","sequence":"first","affiliation":[{"name":"Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0283-030X","authenticated-orcid":false,"given":"Devika","family":"Kamat","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikas Kumar","family":"Panwar","sequence":"additional","affiliation":[{"name":"Urology, AIIMS, Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Udit","family":"Chauhan","sequence":"additional","affiliation":[{"name":"Diagnostic and Interventional Radiology, AIIMS, Rishikesh, Uttarakhand, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,29]]},"reference":[{"key":"2026062906100897000_19.6.e271116.1","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1186\/s13256-021-03058-z","article-title":"Sporadic intra-abdominal desmoid tumor with a very unusual onset: two case reports","volume":"15","author":"Kuwabara","year":"2021","journal-title":"J Med Case Reports"},{"key":"2026062906100897000_19.6.e271116.2","doi-asserted-by":"crossref","DOI":"10.1016\/j.ijscr.2025.111304","article-title":"Giant desmoid tumor of the abdominal wall: a case report","volume":"130","author":"Tormane","year":"2025","journal-title":"Int J Surg Case Rep"},{"key":"2026062906100897000_19.6.e271116.3","first-page":"7653246","article-title":"Pelvic Desmoid Tumor: A Rare Case with Difficult Diagnosis and Treatment","volume":"2022","author":"Ormonde","year":"2022","journal-title":"Case Rep Obstet Gynecol"},{"key":"2026062906100897000_19.6.e271116.4","doi-asserted-by":"crossref","DOI":"10.1016\/j.esmoop.2022.100578","article-title":"Association between recent pregnancy or hormonal contraceptive exposure and outcome of desmoid-type fibromatosis","volume":"7","author":"Debaudringhien","year":"2022","journal-title":"ESMO Open"},{"key":"2026062906100897000_19.6.e271116.5","doi-asserted-by":"crossref","DOI":"10.1016\/j.gore.2021.100901","article-title":"Pregnancy-associated large pelvic desmoid tumor: A case report of fetal-protective strategies and fertility preservation","volume":"39","author":"Marsh-Armstrong","year":"2022","journal-title":"Gynecol Oncol Rep"},{"key":"2026062906100897000_19.6.e271116.6","doi-asserted-by":"crossref","DOI":"10.1038\/s41598-020-60237-6","article-title":"Novel pathogenic alterations in pediatric and adult desmoid-type fibromatosis - A systematic analysis of 204 cases","volume":"10","author":"Trautmann","year":"2020","journal-title":"Sci Rep"},{"key":"2026062906100897000_19.6.e271116.7","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1016\/j.gastha.2023.01.010","article-title":"A Review of the Clinical Presentation, Outcomes, and Treatments of Patients Having Desmoid Tumors","volume":"2","author":"Figueredo","year":"2023","journal-title":"Gastro Hep Adv"},{"key":"2026062906100897000_19.6.e271116.8","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1002\/cncr.35040","article-title":"Trauma and sporadic desmoid tumor development: An approach toward real incidence and aspects of causality","volume":"130","author":"Hohenberger","year":"2024","journal-title":"Cancer"},{"key":"2026062906100897000_19.6.e271116.9","doi-asserted-by":"publisher","DOI":"10.1007\/s11845-022-03008-8"},{"key":"2026062906100897000_19.6.e271116.10","doi-asserted-by":"crossref","first-page":"101750","DOI":"10.1016\/j.gore.2025.101750","article-title":"Acute limb ischemia due to a common iliac artery thrombosis following total pelvic exenteration with pelvic sidewall resection: A case report","volume":"59","author":"Selloua","year":"2025","journal-title":"Gynecol Oncol Rep"},{"key":"2026062906100897000_19.6.e271116.11","doi-asserted-by":"crossref","DOI":"10.3390\/jpm13121653","article-title":"Desmoid Tumors in the Active Surveillance Era: Evaluation of Treatment Options and Pain Relief in a Single-Center Retrospective Analysis","volume":"13","author":"Rastrelli","year":"2023","journal-title":"J Pers Med"},{"key":"2026062906100897000_19.6.e271116.12","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1186\/s13256-021-03088-7","article-title":"Successful treatment with radiation therapy for desmoid-type fibromatosis with unilateral hydronephrosis: a case report","volume":"15","author":"Ishikawa","year":"2021","journal-title":"J Med Case Reports"},{"key":"2026062906100897000_19.6.e271116.13","doi-asserted-by":"crossref","first-page":"3265","DOI":"10.1002\/cncr.32921","article-title":"Certain risk factors for patients with desmoid tumors warrant reconsideration of local therapy strategies","volume":"126","author":"Bishop","year":"2020","journal-title":"Cancer"},{"key":"2026062906100897000_19.6.e271116.14","doi-asserted-by":"crossref","first-page":"8710","DOI":"10.12998\/wjcc.v9.i29.8710","article-title":"Clinical and imaging features of desmoid tumors of the extremities","volume":"9","author":"Shi","year":"2021","journal-title":"World J Clin Cases"},{"key":"2026062906100897000_19.6.e271116.15","doi-asserted-by":"crossref","first-page":"2161","DOI":"10.3390\/diagnostics14192161","article-title":"Different Shades of Desmoid-Type Fibromatosis (DTF): Detection of Noval Mutations in the Clinicopathologic Analysis of 32 Cases","volume":"14","author":"Ajabnoor","year":"2024","journal-title":"Diagnostics"},{"key":"2026062906100897000_19.6.e271116.16","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1805052"},{"key":"2026062906100897000_19.6.e271116.17","doi-asserted-by":"crossref","first-page":"4356","DOI":"10.1002\/cam4.3973","article-title":"Magnetic resonance imaging patterns of tumor response to chemotherapy in desmoid-type fibromatosis","volume":"10","author":"Zanchetta","year":"2021","journal-title":"Cancer Med"},{"key":"2026062906100897000_19.6.e271116.18","doi-asserted-by":"crossref","DOI":"10.1016\/j.tranon.2024.102124","article-title":"A bright future for multidisciplinary approach to cancer care in the setting of limited resource","volume":"50","author":"Dadzie","year":"2024","journal-title":"Transl Oncol"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-271116","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T13:10:31Z","timestamp":1782738631000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-271116"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":18,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6,29]]},"published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1136\/bcr-2025-271116"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-271116","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]}}}