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This is the first report of a desmoid tumor 19 years after radiation therapy for seminoma of the testis at the age of 40. It stresses the need to include the desmoid tumor in the differential diagnosis of an intra-abdominal tumor after treatment of testicular cancer as well as the possible radiation induction of desmoid tumor. Dr. med. Hartmut E.H. Wegner, Urologische Klinik und Poliklinik, Universitätsklinikum Steglitz, Freie Universität Berlin, Hindenburgdamm 30, D-12200 Berlin (FRG) Introduction Fibromatosis covers a wide range of dysplastic connective tissue lesions, with the desmoid tumor representing a particular type. It usually involves the anterior abdominal wall, rarely the mesentery. The desmoid tumor does not metastasize, but has a strong tendency to recur after local excision [1]. Only twice has a desmoid tumor been reported following treatment for testicular germ cell tumors [2, 3], and this is the first report where radiation therapy for a testicular germ cell tumor is presumed to having been casual. Case Report A 40-year-old man had a testicular seminoma that was treated with orchiectomy followed by irradiation of the retroperitoneal, mediastinal, and subclavian nodes (400, 400, 300 Gy, respectively) for lymphographically confirmed metastases, stage lib. The follow-up was uneventful until a big palpable abdominal tumor was detected 19 years later. Metastatic evaluation, including a chest X-ray, complete blood count, liver function studies, human chorionic gonadotropin, α-fetoprotein, and lactic dehydrogenase, was normal. A CAT scan (fig. 1) disclosed a solid intraperitoneal tumor. Lapa-rotomy was performed for the presumed recurrence, and a 10 × 15 × 20 cm grayish-white tumor infiltrating the proximal ileum and ileal mesentery was excised with the adjacent ileum. The patient is well 2 years later. Histological examination revealed slender spindle cells lacking mitotic activity and atypia with abundant collagen and focal hemorrhage. Partial infiltration of the ileal muscularis propria as well as adjacent fatty tissue was detected (fig. 2). The histological diagnosis was fibromatous tumor consistent with desmoid tumor. Discussion D ow nl oa de d by : 54 .7 0. 40 .1 1 11 /1 9/ 20 17 6 :4 9: 34 A M Desmoid tumor is a rare locally invasive fibroblastic proliferation usually arising in the fascia or aponeurosis and infiltrating the adjacent muscle. The tumor lacks the ability to metastasize. Macroscopically, it is firm and grayish. Histologically it is characterized by interwoven spindle cells and varying amounts of collagen; the center is often almost acellular. The vigorous cellularity of the periphery sometimes makes it resemble a fibrosarcoma. Extra-abdominal and abdominal desmoid tumors have the same incidence, the latter usually arising from the posterior sheath of the rectum muscle. Mesenteric desmoid tumor is rare and predominantly afflicts females [1]. The etiology of desmoid tumors is unknown. However, an inherited defect of connective tissue formation with a variable autosomal dominant trait is discussed [4]. Trau© 1994 S. KargerAG, Basel 0042-1138/94/0531-0048 $8.00/0