Full-thickness chest wall reconstruction after resection of recurrent desmoid-type fibromatosis

Abstract

Introduction. Desmoid-type fibromatosis (DF) is a benign but locally infiltrative soft tissue tumor that develops from fascia and musculoaponeurotic tissue with high local recurrence rate. The aim of this article was to present a case of recurrent desmoid-type fibromatosis of the chest wall and chest wall reconstruction after tumor resection. Case outline. A 62-year-old man came for an examination due to a tumor localized on the right anterior chest wall. The patient undergone surgical excision of desmoid-type fibromatosis of the abdominal wall one year ago. Physical examination found a firm and painless 6-7 cm mass on the right side of the chest wall with no swelling of superficial lymph nodes. Computed tomography scan revealed a homogenous mass of soft tissue density, measuring 7.12 ? 4.23 cm, arising from right anterolateral wall of thoracic cage with adjoining ribs destruction. The patient was taken for the operation and right thoracotomy was done with excision of tumor along with resection of 8th, 9th and 10th ribs. The results of pathological examination were consistent with the frozen section, and the patient was diagnosed with DF. Despite the absence of postoperative radiotherapy, there was no evidence of local recurrence two years later. Conclusion. Surgical treatment of recurrent desmoid-type fibromatosis of the chest wall requires a wide resection with negative margins. Multidisciplinary approach in case of full-thickness defect of the chest wall and combination of pedicled muscle flap and polypropylene mesh are important to provide chest wall stability.