PMC5346936_01
Preoperative body imaging study with MRI confirms the presence of a solid mass of about 18 x 10 x 6.4 cm on the left abdominal wall: frontal section (a) and transverse plane (c, e). 12-month postoperative MRI shows no evidence of recurrence of the tumor or incisional hernia: frontal section (b) and transverse plane (d, f).
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In September 2015, magnetic resonance imaging (MRI) was performed for tumor staging (Fig. 1a, c, e), which revealed a marked progression of the disease (calculated size 18 x 10 x 6.4 cm). The abdominal flap was cranially detached; the neoformation invaded completely the left abdominal rectus muscle and partially oblique muscles with an extension of approximately 30 x 20 cm (Fig. 1a, 2a). There was no evidence of recurrence of the tumor or incisional hernia at 12 months of follow-up (Fig. 1b, d, f) and the membrane turned out to be completly incorporated with the sourrounding tissues.
a Intraoperative view of the mass before resection. b Size of the defect created in the abdominal wall after the resection. c Size of the resected tumor. d Egis  membrane 30 x 20 cm used to cover the defect. e The membrane is sutured to the abdominal wall to reconstruct it.
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The abdominal flap was cranially detached; the neoformation invaded completely the left abdominal rectus muscle and partially oblique muscles with an extension of approximately 30 x 20 cm (Fig. 1a, 2a). The rectus muscle and a large portion of the oblique and transverse muscles were removed "en bloc" with 1 cm of healthy margin from the mass (Fig. 2b, c). The not cross-linked porcine dermal matrix Egis  (Decomed, Venice, Italy) 30 x 20 cm, 1.5 mm thick, was hydrated for 10 min in sterile saline solution and then secured with interrupted absorbable suture (Vicryl 2/0) to the fascia and abdominal wall muscles (Fig. 2d, e); another two drains were placed over the matrix.