Extra-Abdominal Desmoid Tumor: Local Recurrence and Treatment Options

Abstract

Objective: To evaluate the rate of local recurrence of extra-abdominal desmoid tumor and compare the outcomes of surgical treatment and conservative treatment.Methods: Twenty one patients (14 women and seven men), mean age 33.0±8.7 years old, with a diagnosis of desmoid tumor were evaluated. The mean follow-up period was 58.5±29.0 months. Fourteen cases involved the lower limbs, four cases involved the upper limbs, and three cases involved the trunk. The average tumor size was 12.7±7.5 cm. Of the 21 patients, 14 did not undergo previous treatment and seven patients relapsed before the initial evaluation. Surgical treatment was performed in 16 patients and conservative treatment was performed in five patients.Results: Recurrence occurred in seven patients (33%) and six of them relapsed within the first 18 months. No significant difference was observed between conservative and surgical treatment. However, a significant difference was observed among patients undergoing wide resection and who experienced improved local control.Conclusion: The recurrence rate of desmoid tumor was 33.3%. There was no difference in recurrence between conservative and surgical treatment. In surgical treatment, wide margins showed better results for recurrence control. Level of Evidence III. Retrospective Observational Study.

Limb Salvage Treatment of Large Multicentric Extra-Abdominal Desmoid Tumor of Lower Extremity

“…A study of 21 patients with DT has shown that gender, age, localization and number of previous recurrences does not affect the recurrence rate of the tumor [11]. We presented a challenging case of DT in which we supported the notion of surgery as treatment of choice, but with functional preservation of anatomical structures.…”

“…Patients with DT usually are young females between 15-35 years [11]. Our patient was 36 year old male, and he was younger, compared to patients described in publications with similar localization (lower limbs) of this tumor type [9,10,12,17,18].…”

“…The lowest rate of recurrence was after surgical treatment with wide resection of tumor margins. If histopathological findings observe tumor infiltration in resected margins, increased rate of recurrence is expected [1,11]. Sometimes surgical wide resection is not possible (as was in our case), because of difficult anatomic localization and often functionally unacceptable results [3].…”

“…The recurrence rate of DT according to Teixeira LE et al is 33%, with 85% presenting in first 18 months after the end of treatment [11]. A study of 21 patients with DT has shown that gender, age, localization and number of previous recurrences does not affect the recurrence rate of the tumor [11].…”

“…So far, the literature describes only several cases of anterior lower limb presentation of desmoid tumor, one case presentation in bilateral lower limbs and there are no literature findings of ipsilateral knee and ankle joint presentation (Table 1) [7][8][9][10]. Volume Patients with DT usually are young females between 15-35 years [11]. Genetical predisposing plays an important role in development od DT, and is often associated with the familial adenomatous polyposis and Gradner's syndrome.…”