# Intramuscular desmoid tumor of the leg leading to external popliteal sciatic neuropathy: A case study and literature review

## TL;DR

A rare case of a desmoid tumor in the leg mimicked sciatic nerve issues, but successful surgery preserved nerve function and prevented recurrence.

## Contribution

This case study highlights the rare occurrence of desmoid tumors in the leg and their diagnostic mimicry of sciatic neuropathy.

## Key findings

- A 44-year-old woman's desmoid tumor was successfully surgically removed without nerve damage.
- The tumor mimicked external popliteal sciatic neuropathy, emphasizing diagnostic challenges.
- Two-year follow-up showed no recurrence, indicating successful surgical management.

## Abstract

Desmoid tumors (DT), rare benign neoplasms of soft tissues, exhibit local aggressiveness and high recurrence rates. Originating from myofibroblast proliferation, complete surgical intervention is the preferred treatment. Despite their benign nature, these tumors are infrequent, predominantly affecting women between 15 and 60, with a higher incidence in adolescence.

A 44-year-old woman with a DT in the leg mimicking external popliteal sciatic neuropathy. Diagnosis confirmed by biopsy, surgery performed with preservation of the external popliteal nerve, ensuring optimal nerve function. Two-year follow-up with no recurrence, demonstrating the success of the surgical intervention.

DTs, although rare, exhibit three distinct genomic mutations, with the 45F genotype associated with the highest risk of recurrence. Generally sporadic, these tumors can be linked to familial adenomatous polyposis (FAP) and influenced by states of hyperestrogenism. DTs typically present as deep-seated masses, with frequent local recurrence despite complete resection.

DTs pose diagnostic and therapeutic challenges, often requiring complete surgical intervention. Management depends on symptomatology, with careful monitoring for small asymptomatic tumors and adjuvant radiotherapy in case of incomplete resection. Despite surgical success, frequent recurrence underscores the need for in-depth research to enhance therapeutic approaches.

•Desmoid tumors, also known as aggressive fibromatoses, are rare and benign neoplasms of soft tissues, constituting less than 3% of soft tissue tumors.•Female Predominance: These tumors primarily affect women and can manifest between the ages of 15 and 60, with a higher incidence in early adolescence, peaking around the age of 30.•Rare Occurrence in the Leg: Although desmoid tumors can develop in various parts of the body, their manifestation in the leg is exceptionally rare, adding to the complexity of diagnosis and management.•Therapeutic Challenges: Managing desmoid tumors poses a challenge. Despite complete resection, the risk of local recurrence remains significant, and there is no clear consensus on the most effective therapeutic approach. Chemoradiotherapy shows limited effectiveness.•Illustrative Case of Mimicry: The study presents a case of a desmoid tumor in the leg mimicking an external popliteal sciatic neuropathy in a 44-year-old patient, highlighting the intricate diagnostic challenges associated with this exceptionally rare neoplastic entity.

Desmoid tumors, also known as aggressive fibromatoses, are rare and benign neoplasms of soft tissues, constituting less than 3% of soft tissue tumors.

Female Predominance: These tumors primarily affect women and can manifest between the ages of 15 and 60, with a higher incidence in early adolescence, peaking around the age of 30.

Rare Occurrence in the Leg: Although desmoid tumors can develop in various parts of the body, their manifestation in the leg is exceptionally rare, adding to the complexity of diagnosis and management.

Therapeutic Challenges: Managing desmoid tumors poses a challenge. Despite complete resection, the risk of local recurrence remains significant, and there is no clear consensus on the most effective therapeutic approach. Chemoradiotherapy shows limited effectiveness.

Illustrative Case of Mimicry: The study presents a case of a desmoid tumor in the leg mimicking an external popliteal sciatic neuropathy in a 44-year-old patient, highlighting the intricate diagnostic challenges associated with this exceptionally rare neoplastic entity.