Background: Desmoid tumours are intermediate, locally aggressive tumours that lack metastatic potential but can significantly impact quality of life. Pain is a common presentation. Hydrodissection is an ultrasound-guided technique in which fluid is injected to create separation between nerves or other anatomical structures and the surrounding soft tissues. Its use in pain associated with desmoid tumours has not previously been described. Case Presentation: We report the case of a 47-year-old female with a sacroiliac junction desmoid tumour. Despite 18 months of conservative therapies, including NSAIDs, opioids, and physical therapy, she continued to experience sacroiliac junction pain. The desmoid tumour had been treated with cryotherapy. The patient underwent ultrasound-guided hydrodissection as a targeted approach to address perineural inflammation and nerve entrapment. 15 mL 5% dextrose solution and 5 mL 0.25% levobupivacaine were used to free the desmoid tumour from surrounding scar tissue and muscle adhesions. The procedure was performed in a theatre setting. Results: Following the hydrodissection procedure, the patient experienced significant pain improvement, which was sustained at two-month follow-up. Functional outcomes, including range of motion and activities of daily living, improved substantially, with no further analgesic requirement at follow-up. No complications were reported. Conclusions: This case suggests that hydrodissection may have a role as a minimally invasive treatment for pain associated with desmoid tumours. No procedure-related complications were observed in this case, and further study is required to evaluate its role in this setting.
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