A Case Report of Successful Treatment of Pelvic Desmoid with Tamoxifen and Indometacin

Shigeru Hibino, Susumu Fujioka, Kenji Kato, Yuichi Machiki, Yasushi Kutsuna, Yasushi Takenouchi, Hideki Matsuba, Hirofumi Morimae, Akihiro Hirata and Katsue Yoshida*

Department of Surgery and Pathology*, Kiryu Kousei General Hospital

A 62-year-old man was referred to another hospital for evaluation of constipation and was admitted to our hospital when a pelvic tumor and right hydronephrosis were discovered. A barium enema showed that the rectum was shifted to the left side. The rectal wall was stenosed circumferentially, but the mucosal layer had a smooth surface. Contrast-enhanced computed tomography showed that the tumor was unclear around the rectum and the right side of the pelvic cavity. The rectum was shifted to the left side, and the wall of the urinary bladder on the right side was irregularly thickened. The right ureter was dilated, and right hydronephrosis was observed. Laparotomy was performed based on a diagnosis of rectal stenosis and right hydronephrosis secondary to a pelvic tumor. The histological diagnosis was intra-abdominal desmoid tumor. Postoperative treatment with Tamoxifen and Indometacin improved the abdominal findings on palpation and the other clinical findings. Treatment of the unresectable pelvic desmoid with Tamoxifen and Indometacin was successful. We discuss intra-abdominal desmoids including the problems of treatment.

Key words
desmoid, tamoxifen, indometacin

Reprint requests
Shigeru Hibino Department of Surgery, Kiryu Kousei General Hospital
6-3 Orihime-cho, Kiryu, 376-0024 JAPAN

Accepted
November 26, 2003

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