Hindawi Publishing Corporation Case Reports in Medicine Volume 2012, Article ID 725498, 4 pages doi:10.1155/2012/725498 Case Report Desmoid Tumor of the Anterior Abdominal Wall in Female Patients: Comparison with Endometriosis H. Krentel,1, 2 G. Tchartchian,3 and R. L. De Wilde4 1 Department of Obstetrics and Gynecology, Hospital Eisenhu¨ttenstadt, Friedrich-Engels-Str. 39, 15890 Eisenhu¨ttenstadt, Germany 2 CEGPA, Av. Guardia Civil 135, San Borja, Lima, Peru 3 MIC Clinic Berlin, Kurstr. 11, 14129 Berlin, Germany 4 Department of Obstetrics and Gynecology, Pius Hospital, Georgstr. 12, 26121 Oldenburg, Germany Correspondence should be addressed to H. Krentel, hkrentel@yahoo.de Received 31 January 2012; Revised 30 April 2012; Accepted 8 May 2012 Academic Editor: Valerae O. Lewis Copyright © 2012 H. Krentel et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In female patients presenting a tumor of the lower abdominal wall especially after cesarian section, an endometriotic tumor as well as an aggressive desmoid tumor should be considered. Symptoms in correlation with the monthly period can facilitate the presurgical diﬀerentiation between endometriosis and ﬁbromatosis. Ultrasound reveals the typical location of both tumors and its remarkable sonographic appearance. In the clinical practice, the desmoid ﬁbromatosis of the lower abdominal wall is a very rare disease. We present a case of a 25-year-old pregnant and discuss diagnostic and therapeutic options by a PubMed literature review. With the knowledge of the prognosis of the desmoid ﬁbromatosis and the respective treatment options including wait and see, complete surgical resection with macroscopically free margins and adjuvant approaches is essential to avoid further interventions and progression of the locally destructive tumor. 1. Introduction Pregnant women with a cesarean section in their clinical history occasionally present a tumor of the lower anterior abdominal wall. In many cases, the tumor located close to the C-section scar appears in the second or third trimester of an actual pregnancy is palpable and temporarily causes pain. An irregular, inhomogeneous focus can be found in sonographic examination with the convex scan. Mostly the clinical diagnosis is endometriosis. The tumor resection as part of the C-section is the usual treatment. In this paper we present a desmoid ﬁbromatosis of the lower abdominal wall in a young pregnant woman and discuss the treatment options of desmoid tumors in pregnancy and the diﬀerenti- ation in diagnosis and treatment between endometriosis and desmoid-type tumors considering the results of a literature review. The correct pre- and intraoperative diagnosis of this rare disease is the most important factor for the respec- tive treatment and prognosis of the destructive desmoid ﬁbromatosis. 2. Case Presentation In this paper we describe the case of a 25-year-old woman with 38 weeks of gestation and a symptomatic tumor of the lower abdominal wall. We supposed the tumor to be a scar endometriosis as the patient had a previous caesarian section and the tumor was located 2 cm cranial to the scar. Therefore, a preoperative diagnostic cytology has not been performed. The presurgical examination showed a dense and painful mass with a diameter of 3-4 cm. Ultrasound revealed a subfascial, intramuscular localization. The tumor did not disturb the uterus and the pregnancy. As a caesarian section has been planned, we decided to resect the tumor within the surgery. After successful child delivery and closure of the uterine tissue and the peritoneum, we found a dense, incompressible, grey tumor in the right rectus sheath with a local inﬁltration of the rectus muscle. A local com- plete resection with a macroscopically tumor-free margin was performed. The tumor size of not more than 3 cm allowed the resection without any functional limitations.