A 41-year-old woman consulted to our for a painful mass in her left flank and left iliac fossa that has evolved for four months without fever, vomiting, nausea, or any symptom of gastrointestinal obstruction. Her surgical past was remarkable by a Caesarean section one year ago. She was a non-smoker with no drugs use, and had no history of allergies. The history of her family is unremarkable, as there is no similar case reported in the family or proven genetic abnormalities. The physical examination finds a soft and tender abdomen with the presence of a Pfannenstiel scar. Moreover, a mass occupying her left flank and left iliac fossa was palpated. The mass was non-compressible, freely mobile, and non-pulsatile. To evaluate the abdominal mass detected by the physical examination. Abdominopelvic CT-scan was performed () showing an ovoid mass suggestive of a desmoid tumor measuring 109*59 mm extended over 76 mm occupying the left anterolateral wall of the abdomen reaching the left iliac crest with intimate contact with the sigmoid loop, the abdominal MRI objectified a well-limited mass, with lobulated contours showing a T1 iso-intensity and a heterogeneous T2 hyperintensity, inflicting the rectus abdominis muscle and pushing outwards the left flat muscles of the abdomen as well as the iliacus muscle posteriorly and arriving at the contact of the left iliac crest below (see ). She underwent a midline laparotomy, intraoperative exploration revealed a parietal mass infiltrating the sub umbilical left rectus muscle, the left iliac crest, and the left anterosuperior iliac spine with adhesions to the greater omentum and the sigmoid colon. We decided to realize a complete excision of the mass for curative resection. We proceeded to a total resection of the mass taking away the left rectus muscle and a part of the remaining muscle of the left abdomen wall with reconstruction by a pedicled flap of the left Fascia lata with the placement of a bifacial mesh with abdominal parietal drainage.(). The procedure was achieved by a chief of general surgery. Postoperatively, analgesia, antibiotics, and prophylaxis for thromboembolism has been administered. The patient adhered to and tolerated the advice provided such as heavy lifting, and the use of abdominal support belt. The histological examination found a fusocellular proliferation made of long and wide bundles that are inserted between the bundles of the striated muscle (in fingers of gloves). The tumor cells have elongated and sometimes undulating nuclei and eosinophilic cytoplasm with imprecise boundaries in favor of a desmoid tumor, the proliferation is based on an abundant keloid-like collagenous background which becomes focally lax. The patient's post-operative recovery was without incident, The drain was removed on the fourth postoperative day and she was discharged on the fifth postoperative day. After a Follow up of one year after surgery, there was no evidence of recurrence.