Ligament-like tumor of the abdominal wall, does it come from the ligament? Benign or malignant, it is better to listen to a story. Seven years ago, the rural boy Wang found a small nodule on the abdominal wall, not painful, so did not take it seriously, after a year the nodule slightly larger than the original, at the urging of his wife went to the county hospital to see, at the suggestion of the surgeon did surgery to remove, the post-operative pathology diagnosis is “ligament-like tumor”, remember the doctor saw the report frowned, told the young couple that this thing is not malignant, but still have I remember the doctor frowned at the report and told the couple that it was not malignant, but there was still a possibility of recurrence and they needed to be followed up every six months. The doctor diagnosed that the ligament-like tumor had recurred and that the couple should have another surgery, this time with a slightly larger scope. However, what Xiao Wang experienced was another recurrence and then another surgery, and so he went through three surgeries in the past six years, and the incision on his abdominal wall became bigger and bigger, and the scar became more and more unsightly, but recently there was a third recurrence. The three doctors who operated on Xiao Wang said that the tumor was not malignant, and that metastasis recurrence is only for malignant tumors, so why does the tumor that is not malignant keep recurring? Where did the ligament-like tumor come from, was it a ligament? Why is it so strong and stubborn? In fact, this tumor does not originate from ligament, but from the fibrous connective tissue of the abdominal wall. Due to the formation of a large number of hard fibers, the pathology looks close to ligament, so it is called “ligament-like tumor”. Another more standard name is “Desmoid”. Why does it recur even though it is not malignant? In fact, it is a junctional tumor, that is, a tumor whose biological behavior is between benign and malignant. It looks like a benign tumor in appearance and growth rate, for example, it looks like a nodule and does not grow fast, but it grows like a malignant tumor in an infiltrative manner. We often compare it to a tumor that grows into the surrounding and deeper tissues like the roots of a tree, and the tiny endings are not visible to the naked eye or even easy to find under the microscope, so it appears to be very strong and stubborn. If the mass itself is removed without removing the surrounding healthy-looking tissues that may infiltrate and grow, the inevitable result is recurrence, so we need to do an enlarged resection of the tumor with 2-3 cm of surrounding normal tissues. If the tumor itself is 3cm, and the tumor expands 2-3cm in all directions, then the diameter of the abdominal wall will be 7-8cm, and the muscle will be contracted 2-3cm after resection. /Therefore, it is very difficult for surgeons to repair such a large defect, and even if it is repaired, if it does not heal well, an abdominal wall hernia will occur. Therefore, surgeons will be concerned when doing surgery, and the scope will easily become smaller, and the recurrence rate will be very high if the scope is small, so it is easy to have recurrence after cutting, recurrence after cutting again, and then recurrence again. Only a standard enlarged excision can reduce the recurrence rate to a minimum. As mentioned earlier, enlargement defects inevitably result in large defects of the abdominal wall musculature, which is the main component supporting the abdominal wall, and even if the skin on the surface and the peritoneum inside are intact, a loss of the musculature can lead to hernia, so it is important for surgeons treating abdominal wall sclerofibromas to have the skills to reconstruct the abdominal wall. Reconstruction techniques are diverse and vary from person to person; we can use patch repair, we can use abdominal wall component separation techniques, we can use myocutaneous flap transfer techniques, we can include skin grafting, etc., and often a combination of several techniques is required. This is a challenge for most surgeons, so we still need specialized abdominal wall surgeons and even a plastic surgeon to work together to accomplish a good reconstruction of the abdominal wall so that the appearance and function can be close to the normal preoperative level. Xiao Wang underwent a second surgery with an enlarged resection followed by a patch repair to reconstruct the abdominal wall, and now almost two years after his fourth surgery, we sincerely hope that he will be able to live a healthy and happy life without recurrence.