Laparoscopic-Assisted Percutaneous Cryoablation of Abdominal Wall Desmoid Fibromatosis: Case Series and Local Experience

Background: Desmoid tumors (DTs) are rare, non-metastatic but locally aggressive connective tissue neoplasms. While standard treatments include surgery, radiation, and ablation, current guidelines advocate active surveillance unless tumors progress or symptoms worsen. Cryotherapy has shown promise in treating DTs; however, its application in rectus abdominis DTs has been limited due to proximity to critical intra-abdominal structures. Methods: This case series describes a novel approach involving laparoscopic-assisted cryoablation in three patients with rectus abdominis DTs. Laparoscopic visualization was employed to improve tumor localization and procedural safety during percutaneous cryoablation. Results: The average tumor size was 7.4 cm, and a mean of 14 cryoprobes were used per case. All patients experienced complete symptom resolution. One patient developed a complication—injury to the inferior epigastric artery—requiring embolization. Follow-up imaging at three months showed significant tumor shrinkage and necrosis in two patients. The third patient had increased lesion volume due to post-procedural hematoma, although radiological markers of cryoablation efficacy were present. Conclusions: Laparoscopic-assisted cryoablation appears to be a feasible and effective technique for treating rectus abdominis DTs, providing symptom relief and favorable early tumor response. Further studies are warranted to evaluate long-term outcomes and validate this approach in broader clinical settings.