This document provides tips for using a PowerPoint presentation on abdominal wall tumors. It recommends: 1. Freely downloading, editing, and modifying the slides and adding your name. 2. Not worrying about the number of slides, as half are blank except for the title to facilitate active learning sessions. 3. Initially showing the blank slides to elicit what students already know before presenting the content. 4. Rerunning the presentation at the end by again showing blank slides and asking questions. 5. This approach facilitates active learning through three revisions of the material. The notes also provide bibliographic references.

1. Tips on using my ppt.
1. You can freely download, edit, modify and put your
name etc.
2. Don’t be concerned about number of slides. Half the
slides are blanks except for the title.
3. First show the blank slides (eg. Aetiology ) > Ask
students what they already know about ethology of
today's topic. > Then show next slide which enumerates
aetiologies.
4. At the end rerun the show – show blank> ask questions >
show next slide.
5. This will be an ACTIVE LEARNING SESSION x
three revisions.
6. Good for self study also.
7. See notes for bibliography.

2. Introduction & History.

3. Introduction & History.
• Abdominal wall iscomposed of
abdominal muscles and thier aponeuroses.
• Tumour is synonymus with neoplasm.
• Abdominal wall tumours are rare diseases.
• Tumours of abdominal wall are mainly
following
1. Desmoid tumour
2. Fibrosarcoma of the abdominal wall
3. Adenocarcinoma of abdominal wall

4. Classification

5. Classification
• Abdominal wall tumours -
1. Benign Leiomyoma
2. Malignant –
1. Primary
• Desmoid tumour
• Fibrosarcoma
• Leimyosarcoma
2..Metastasis
• Adenocarcinoma

6. Desmoid tumour

7. Etiology

8. Etiology
• Idiopathic
• Congenital- Genetic/Sporadic
• Traumatic
• Infections /Infestation
• Autoimmune
• Neoplastic (Benign/Malignant)
• Degenerative
• Endocrine.

9. EndocrineEtiology
• Most commonly appear in young women
during or after pregnancy.
• The tumors regress during menopause
• and after tamoxifen treatment.
• May regress after exposure to oral
contraceptives.

10. Desmoid tumour:Pathophysiology

11. Desmoid tumour:Pathophysiology
• Myofibroblasts is cell of origin
• Fibrous neoplasms originating from the
musculoaponeurotic structures throughout
the body.
• The term desmoid, coined by Muller in
1838, is derived from the Greek
word desmos, which means tendonlike.
• The synonym aggressive fibromatosis
describes the marked cellularity and
aggressive local behavior.

12. Desmoid tumour:Pathophysiology
• Desmoid tumors often appear as infiltrative,
usually well-differentiated, firm
overgrowths of fibrous tissue, and they are
locally aggressive.

13. Clinical Features

14. Clinical Features
• Demography
• Symptoms
• Signs
• Prognosis
• Complications

15. Demography
•

16. Demography
• 0.03% of all neoplasms.
• When present in patients with familial
polyposis of the colon, the prevalence of
desmoid tumors is as high as 13%.
• more common in persons aged 10-40
years
• most commonly occur in women after
childbirth. Desmoid tumors are twice as
common in females.

17. History
• Trauma/Surgery/childbirth/breast implant
• Familial polyposis coli

18. Symptoms

19. Symptoms
• Abdominal wall Swelling.
• Rarely-
– Shoulder
– Leg
– Retroperitoneal
– Breast

20. Investigations

21. Investigations
• Laboratory Studies
– Routine
– Special
• Imaging Studies
• Tissue diagnosis
– Cytology
• FNAC
– Histology

22. Diagnostic Studies

23. Diagnostic Studies
Imaging Studies
• X-Ray
• USG
• CT
• Angiography
• MRI
• Endoscopy
• Nuclear scan

24. Tissue diagnosis

25. Tissue diagnosis
• The preferred diagnostic test is biopsy of
the tumor. >Immunostaining
• Electron microscopy
• A fine-needle aspiration biopsy
• APC mutational analysis

26. Histologic Findings
• .

27. Histologic Findings
• Abundant collagen surrounding poorly
circumscribed bundles of spindle cells.
• Regular nuclei and pale cytoplasm with
neither mitoses nor giant cells.
• Macrophages, giant cells, and lymphocytes
are present peripherally.
• Fibrosarcoma, which has greater mitotic
activity, an increased nuclear-to-cytoplasm
ratio, greater vascularity, less collagen
production, and a paucity of immune cells.

28. Other tests
• Colonoscopy and fundal examination are
indicated to investigate for the presence
of Gardner syndrome

29. D/D

30. D/D
• Fibrosarcoma

31. Management

32. Management
• Aggressive, wide surgical resection is the
treatment of choice.
• frozen sections followed by immediate
mesh reconstruction
• Radiation therapy
• Pharmacologic therapy with antiestrogens
and prostaglandin inhibitors
• A chemotherapeutic regimen of
doxorubicin, dacarbazine, and carboplatin
• Targeted therapy with imatinib

33. Follow up
• After surgery, MRI may be useful for
monitoring desmoid tumor recurrence.

34. Get this ppt in mobile
1. Download Microsoft
PowerPoint from play
store.
2. Open Google assistant
3. Open Google lens.
4. Scan qr code from
next slide.

36. Get this ppt in mobile
1. Download Microsoft
PowerPoint from play
store.
2. Open Google assistant
3. Open Google lens.
4. Scan qr code from
next slide.

39. Get my ppt collection
• https://www.slideshare.net/drpradeeppande/
edit_my_uploads
• https://www.dropbox.com/sh/x600md3cvj8
5woy/AACVMHuQtvHvl_K8ehc3ltkEa?dl
=0
• https://www.facebook.com/doctorpradeeppa
nde/?ref=pages_you_manage