Development and rapid growth of a desmoid tumor in the surgical corridor after suboccipital craniotomy for recurrent low-grade astrocytoma.

Abstract

Desmoid tumors are histologically benign but locally invasive tumors that can occur in the head and neck. We present the rare case of a desmoid tumor that occurred in the surgical corridor after suboccipital craniotomy for recurrent low-grade astrocytoma. A 30-year-old woman underwent a repeat suboccipital craniotomy for recurrent low-grade astrocytoma. A gross total resection was achieved. Nine months later, a firm, palpable mass was noted near the surgical scar. No new neurologic deficits were noted on exam. A magnetic resonance imaging scan demonstrated a homogeneously enhancing lesion superficial to the dural graft. Surgical resection of the lesion was performed through the original midline incision. The mass was resected en bloc. Histology demonstrated clear surgical margins and a tumor of low cellularity consistent with a desmoid tumor. Desmoid tumors should be considered in the differential diagnosis for superficial masses occurring in the surgical bed after posterior cervical surgery.