Management of aggressive fibromatosis (Review)

Abstract

Aggressive fibromatosis or desmoid tumor is a rare disease resulting from fibroblasts which do not metastasize. However, desmoid tumors belong to low-grade malignant tumors since they have high potential to infiltrate surrounding tissues, causing high local recurrence rates and may affect surrounding organs, threatening life quality and expectancy. Although surgery, watch and wait, radiotherapy, chemotherapy, high intensity focused ultrasound, ablation techniques or several agents have all been frequently investigated for the treatment of this type of disease, none are deemed as standard therapy for high recurrence rates that have been supported by any data. The present review retrieved literature on treatment options for desmoids to summarize the latest treatment modalities and refine their efficacy, as well as their side effects, in order to provide a more comprehensive treatment reference for clinicians.

Flavonoids: A Myth or a Reality for Cancer Therapy?

“…In rats, it prevented the myocardial complications of hypercholesterolemia-triggered oxidative stress through the activation of endothelial nitric oxide synthase and Nrf2 target genes such as SOD (superoxide dismutase) and catalase [57]. Furthermore, chrysin significantly inhibited proliferation and induced apoptosis on human cervical cancer cells [58] and colorectal cancer cells [59] by modulating various apoptotic genes and AKT/MAPK pathway genes. These results highlight two distinct mechanisms through which flavonoids determine the effects on inflammation and cell proliferation: on the one hand, they activate the Nrf2 pathway to inhibit NF-kB and trigger the anti-inflammatory effect; on the other hand, they act on cell proliferation by modulating the genes involved in apoptosis and the AKT/MAPK (protein kinase B/mitogen-activated protein kinase) pathway.…”

A rare sporadic pancreatic desmoid fibromatosis with splenic vein invasion diagnosed by CT scan-guided core needle biopsy: a case report with possible differential diagnosis from metastatic colorectal or renal cancer

“…DTs (also called aggressive fibromatosis) are benign, slow-growing fibroblastic neoplasms with no metastatic potential but a tendency for local recurrence (8–31%) [ 8 ], even after complete surgical excision. Even though histologically benign, they are locally infiltrative and can cause death through invasion of adjacent vital structures and organs [ 9 ].…”

Evolving strategies for management of desmoid tumor

“…54 Percutaneous cryoablation uses argon gas through a sealed, segmentally insulated probe to cause rapid cooling. 53 This has been used in a limited number of patients with extraabdominal DTs and was associated with tumor volume reductions and symptom improvements with low rates of complications. 55,56 This technique, however, may be limited to small-to-moderate sized extra-abdominal tumors.…”

“…High-intensity focused ultrasound (HIFU) is minimally invasive, using ultrasound beams precisely focused on target locations to produce thermal coagulation necrosis. 53 In 111 patients with DTs, ultrasound-guided HIFU provided a 36% 3-month tumor volume reduction rate with the most common adverse events (AEs) being pain (14%; all Grade 1 or 2) and bone reaction (10%; all Grade 1). 54 Percutaneous cryoablation uses argon gas through a sealed, segmentally insulated probe to cause rapid cooling.…”

“…In 111 patients with DTs, ultrasound‐guided HIFU provided a 36% 3‐month tumor volume reduction rate with the most common adverse events (AEs) being pain (14%; all Grade 1 or 2) and bone reaction (10%; all Grade 1) 54 . Percutaneous cryoablation uses argon gas through a sealed, segmentally insulated probe to cause rapid cooling 53 . This has been used in a limited number of patients with extra‐abdominal DTs and was associated with tumor volume reductions and symptom improvements with low rates of complications 55,56 .…”